Continuous axillary brachial plexus block

Continuous axillary brachial plexus block was performed in 597 patients undergoing prolonged operations on the hand. The technique required placement of a 5 cm 23 gauge teflon intravenous catheter in the axillary perivascular sheath. Lidocaine 1.5 per cent or mepivicaine 1.5 per cent (20-40 ml) were used for the initial block dose. Surgery was completed in 77.2 per cent of patients (460) with the axillary block alone while in 19.1 per cent of patients (114) supplementary narcotic administration or additional regional blocks were required. In 3.7 per cent of patients (22) the technique was considered a complete failure. Complications included local anaesthetic toxic reactions (2.85 per cent, 17 cases), nerve injury (0.50 per cent, three cases) and one case of major haematoma formation. The advantages of this technique and the possible complications are discussed.