Comparison of the effect of EMLA and semicircular subcutaneous anaesthesia in the prevention of tourniquet pain during plexus block anaesthesia of the arm.

In 54 patients who were to undergo surgery of the upper extremity in plexus block anaesthesia the effect of 5 g EMLA (group E) on tourniquet pain was examined and compared with the effect of a semicircular subcutaneous anaesthesia using 10 ml 0.25% bupivacaine (group B) or 10 ml 1% mepivacaine (group M). Among the patients with satisfactory brachial plexus analgesia allowing for surgery (n = 51), the incidence of tourniquet pain was not significantly different between groups E, M and B. Notably, there was no significant difference in the time of tourniquet application. We conclude that topical application of EMLA is as effective as a semicircular subcutaneous anaesthesia with mepivacaine or bupivacaine in the prevention of tourniquet pain during brachial plexus anaesthesia.