Identification of complications and side effects with axillary approach to the brachial plexus block while using lignocaine hydro chloride: A clinical study

The axillary approach to brachial plexus blockade provides satisfactory anaesthesia for elbow, forearm, and hand surgeries also provides reliable cutaneous anaesthesia of the inner aspect of the upper arm including the medial cutaneous nerve of arm and intercostobrachial nerve, areas often missed with other approaches. In addition, the axillary approach remains the safest of all the other approaches as it does not risk blockade of the phrenic nerve, nor does it have the potential to cause pneumothorax, making it an ideal approach for day care surgery. Historically, single-injection techniques have not provided reliable blockade in the musculocutaneous and radial nerve territories, but success rates have greatly improved with multiple-injection techniques whether using nerve stimulation or ultrasound guidance. The present study has been undertaken to evaluate the complications and side effects during axillary approach to brachial plexus. The study was conducted on 50 patients of age between 15 to 65 years of either sex (using 1.5% lignocaine hydrochloride with epinephrine. one patient developed restlessness and two cases of accidental puncture of axillary artery occurred during performance of the procedure. The procedure was repeated after applying firm pressure over the artery for 5 minutes. Quality was excellent in 48% (n=24), Good in 44% (n=22), Fair 4% (n=2) and Poor/Failure in 4% (n-=2).