Background: . Surgical healthcare across low- and middle-income countries is plagued with concerns over scarcity of anaesthesiologists. Orthopaedic surgeons working in such resource-limited settings are often caught in a dilemma to provide emergency orthopaedic surgical care without an attending anaesthesiologist. Therefore, an effective, low-risk solution is necessary to ensure safe emergency orthopaedic care.
Methods: . We evaluated the incidence of 'anaesthesia-related complications' and 'intraoperative adjuvant medications' for maintenance of adequate anaesthesia for patients who underwent emergency upper limb procedures at a remote mission hospital in rural central India, from June 2013 to June 2016. Emergency cases where there was no anaesthesio-logist were analyzed. Data were collected from the Hospaa 3 HMS software, orthopaedic surgical logbook and inpatient records from 2013 to 2016.
Results: . Sixty-eight patients underwent an 'axillary block' for emergency orthopaedic procedures. Twelve (17.6%) patients had partial block and needed adjuvant medications, 1 (1.4%) patient developed ulnar nerve palsy with partial recovery. Seventy-six adjuvant medications were administered at a mean of 1.19 per patient during the intraoperative period.
Conclusions: . Axillary regional block is an efficacious, low-risk anaesthesia for emergency orthopaedic procedures of the hand, forearm and elbow, in resource-limited settings where an anaesthesiologist is not available.