Tehran: International Journal of Scientific Research in Dental and Medical Sciences International Journal of Scientific Research in Dental and Medical Sciences 2676-5497 8 1 2026 03 01 Comparison of Incidence of Tourniquet Pain with Ultrasound-guided Infraclavicular and Axillary Approach of Brachial Plexus Block in Adult Patients: A Randomized Controlled Trial 33 39 254221 10.30485/ijsrdms.2026.552962.1715 EN Mamta Bhardwaj Department of Anaesthesiology & Critical care, Pt. BD Sharma PGIMS, University of Health Sciences, Rohtak, India 0000-0002-3942-3268 Karishma Dhankhar Department of Anaesthesiology & Critical care, Pt. BD Sharma PGIMS, University of Health Sciences, Rohtak, India 0009-0005-2327-085X Kiranpreet Kaur Department of Anaesthesiology & Critical care, Pt. BD Sharma PGIMS, University of Health Sciences, Rohtak, India 0000-0003-3592-0061 Ashish Yadav Department of Anaesthesiology & Critical care, Pt. BD Sharma PGIMS, University of Health Sciences, Rohtak, India 0000-0002-4279-7818 Karthik Manoharan Department of Anaesthesiology & Critical care, Pt. BD Sharma PGIMS, University of Health Sciences, Rohtak, India 0009-0007-0031-2011 Anuj Tripathi Department of Anaesthesiology & Critical care, Pt. BD Sharma PGIMS, University of Health Sciences, Rohtak, India 0009-0001-2917-1992 Journal Article 2026 01 14 Background and aim: Tourniquet pain is a common concern during upper-limb surgery under brachial plexus block. This study compared the incidence and severity of tourniquet pain following ultrasound-guided axillary (AX) and infraclavicular (IC) brachial plexus blocks. Material and methods: In this prospective randomized controlled trial, 44 adults aged 18–60 years, classified as ASA I–III and undergoing upper-limb surgery requiring a tourniquet for more than 45 minutes, were randomized to receive ultrasound-guided AX or IC brachial plexus block. Both groups received 24 mL of local anesthetic. We assessed tourniquet pain using a visual analog scale (VAS). We also evaluated block characteristics, procedural time, adverse events, and patient and surgeon satisfaction. Results: We analyzed 22 patients in the AX group and 21 in the IC group after one patient in the IC group experienced block failure. Tourniquet pain occurred in 6 patients (27.3%) in the AX group and 2 patients (9.5%) in the IC group, with no statistically significant difference (p=0.240; RR=0.35, 95% CI: 0.08–1.54). Four AX patients had mild pain, and two had moderate pain, while both IC patients had mild pain. Needling time (p=0.006) and total block performance time (p=0.016) were significantly longer with IC block. Other block characteristics, adverse events, and satisfaction scores were comparable. Conclusions: We found no statistically significant difference in the incidence or severity of tourniquet pain between ultrasound-guided AX and IC brachial plexus blocks. IC block required a longer procedural time.

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