A comparative study between bier’s block and axillary brachial plexus block for upper limb below elbow surgery

Abstract

Introduction: Intravenous regional anaesthesia is a simple method of producing analgesia of the arm or leg by intravenous injection of a local anaesthetic, while the circulation is occluded. However, it was not long before simple and reliable techniques of brachial plexus block were developed and the intravenous method declined in its popularity. IVRA is a simple procedure and easily applicable, economical and time saving. Aims: This is a study conducted to compare two regional anaesthesia techniques i.e. the axillary brachial plexus block and Bier’s Block with respect to Onset of analgesia, Degree of sensory and motor blockade, duration of analgesia and Complications. Materials and methods: A comparative study of axillary brachial plexus block and intravenous regional anaesthesia was carried out in Sixty patients of the age group 15 and 50 years of both sexes requiring both elective and emergency surgery of the upper extremity below elbow were selected and divided into two groups of 30 patients each. Results: IVRA appears to be a better alternative with regards to the onset of analgesia, the quality of analgesia and degree of motor blockade. More recent studies are more in favor of using adjuvants to local anaesthetics in IVRA which improved the quality of blockade and also the post-operative outcome with regards to analgesia even though it is not as comparable as brachial blockade. Conclusion: IVRA stands out as a better alternative for regional blockade indicated in upper limb surgeries below the elbow joint.