Sorry Rowley, but along with Graham Gardner, I feel I have to stand in
defence of the axillary nerve block.
It's definitely the gentlest form of anaesthesia for the patient (main
advantage).
It also requires only one doctor, monitoring only for the 2 minutes it
takes to inject (I use a blue butterfly) - and, even better, allows you to
go and do something else in the 30-40 minutes it takes for the arm to cook
(I use lignocaine 1%, but intend to try Graham's suggestion of prilocaine
for the next few).
In those days when everyone seems to be FOOSH - SOI (slipped on ice!) the
'something else' can become the next patient to be pulled, thus creating a
highly efficient conveyor belt of patients through the department!
One anaesthetist I worked with deliberately hits the artery first, then
withdraws a millimetre or so, so he know he's in the right place (lawyers
sue blah blah, I know).
Perhaps Graham could tell me if he injects both 'north' and 'south' of the
artery, as I was taught, or are 2 injections unnecessary? Also, is the
cooking time the same as for lignocaine?
Thanks.
Ffion Davies
Ex-Mersey-transferred-to-Anglia-currently-at-Norwich-SpR
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