None listed
Conditions
Brief summary
Pneumatic tourniquet has been used in hands and forearm surgery to reduce blood loss. When the tourniquet is used for a longer period under general anaesthesia, rapid heart rate and high blood pressure can be observed. This is often referred to as ‘tourniquet pain’. In awake patients, tourniquet pain is experienced as a vague, dull aching pain in the affected limb associated with an increased blood pressure. Intercostobrachial nerve supplies sensation to the skin of the armpit and inner side of the upper arm. The nerve lies just below the skin and can be easily blocked to help with upper arm tourniquet pain. The purpose of this study is to determine the efficacy of intercostobrachial nerve block which could reduce pain from tourniquet on the upper arm. Patients who suit the participation in the study will be randomised to either group (intercostobrachial nerve block with lignocaine or saline). The pain score will be assessed every 5 minutes after the touniquet is inflated.
Interventions
Intercostobrachial nerve block will be performed with 5 ml solution (study drug which is either 1% lignocaine or saline as placebo). At 5 minutes after the intercostobrachial nerve block with the study drug, the sensation on the medial site of the forearm will be checked with ice. Then,axillary brachial plexus block will be performed with 20 ml of local anaesthetics (10 ml of 2% lignocaine and 10 ml of 0.75% ropivacaine).
A tourniquet will be inflated just before starting the surgery.
The pain
Intercostobrachial nerve block will be performed with 5 ml solution (study drug which is either 1% lignocaine or saline as placebo). At 5 minutes after the intercostobrachial nerve block with the study drug, the sensation on the medial site of the forearm will be checked with ice. Then,axillary brachial plexus block will be performed with 20 ml of local anaesthetics (10 ml of 2% lignocaine and 10 ml of 0.75% ropivacaine). A tourniquet will be inflated just before starting the surgery. The pain score will be assessed every 5 minutes after the tourniquet is inflated.
Sponsors
Department of Anaesthesia and Pain Medicine at Royal Perth Hospital
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Forearm operation Suitable for axillary brachial plexus nerve block
Exclusion criteria
Age less than 18 Weight less than 50 kg Unable to give informed consent themselves Intravenous drug users Chronic pain patients Those who are contraindicated to the nerve block Expected tourniquet inflating time is less than 45 minutes
Outcome results
None listed