We investigated the effect of distal tourniquet to the proximal spread of local anesthetics in the axillary brachial plexus block.

In this prospective, randomized, controlled trial, 60 patients undergoing elective surgery were divided into two equal groups; Group I (2% mepivacaine 20 ml plus 1% lidocaine 20 ml with 250 mmHg of distal tourniquet) and Group II (2% mepivacaine 20 ml plus 1% lidocaine 20 ml alone). Patients were left for 30 minutes after an axillary brachial plexus block with paresthesia and single injection technique. Sensory blockades were evaluated by pin prick test at each nerve dermatome.

There was no significant difference of sensory blockade in radial nerve, but there were significant differences of sensory blockade in ulnar, median, musculocutaneous, medial antebrachial cutaneous, and axillary nerves (P < 0.05).

Our findings suggest that the quality and effect of axillary brachial plexus block in group with distal tourniquet is better than the control group.