If you wish to respond to a paper or other item already published in the BJA, please go to the abstract/full text version of that item and click on the link "E-Letters: Submit a response to the article".
Electronic Letters to:
|
|
E-letters: Electronic letters published:
-
![[Read E-letter]](/icons/misc/sectionDOWN.gif)
The Tourniquet Pain
- SENTHIL K VIJAYAN (13 April 2006)
|
|
|||
|
SENTHIL K VIJAYAN, SHO, Anaesthesia Swansea
Send letter to journal:
|
Sir, Iam writing with reference to the study done comparing the the two techniques for ultrasound guided infraclvicular block. First I would like to congratulate the authors about this well conducted study. I am sure ultrasound guided regional blocks are the future from now on. As clearly mentioned,the primary aim of the study was to determine incidence of tourniquet pain, vascular puncture and to find the technique with least complicatios rate.Tourniquet pain has always been a major problem with most of upper limb blocks. Going back to the anatomy, the tourniquet pain is caused by intercostal brachial nerve, medial brachial cutaneous nerve branch and in some patients by axillary nerve supplying long head of triceps. In both these techniques axillary nerve is not completely blocked as it arises quiet high from the posterior cord, above the point of puncture. So 17 patients in LIT group and 3 patients in MIT group had tourniquet pain. The best way to tackle the tourniquet pain is subcutaneous fan shaped infiltaration of axilla with 0.25% chirocaine or 1% lignocaine proximal to the tourniquet. References Raj PP, MOntgomery SJ, Nettles D, Jenkins MT. Infraclavicular Brachial plexus block- a new approach. Anaes Analg 1973; 52:897-904 Sandhu NS, Caplan LM. Ultasound guided infraclavicular brachial plexus block. BJA 2002: 254-9 Borgeat A, Ekatodramis G, Dumont C. An evalution of the infraclavicular block via a modified approach of the Raj technique, Anaesth Analg 2001: 436-41 Conflict of Interest:None declared |
|||