A prospective audit of regional anaesthesia for hand surgery.

A prospective audit has been carried out of 153 consecutive regional anaesthetics for hand surgery, using intravenous regional anaesthesia (IVRA), axillary block or multiple peripheral nerve blocks in the upper limb. Surgery was carried out successfully in 147 patients. Apart from two patients, who complained of paraesthesia after regional nerve blocks, there were no side-effects. A total of 13 patients said that they would have preferred a general anaesthetic. Regional anaesthesia was found to be suitable for use by members of the surgical staff, but success was only assured by meticulous attention to detail and by careful safety precautions. Regional anaesthesia should not be attempted by inexperienced, unsupervised hand surgeons.