Fire risk during eye surgery

and supraclavicular block durations have not been compared in a prospective randomised manner, but if data are extrapolated from other brachial plexus locations [4], any difference is unlikely to be of clinical relevance for postoperative analgesia. Subash and Hilton’s experience with single injection supraclavicular block is quite exceptional – in particular that ‘local anaesthetic infusions are rarely required’ for procedures presumably including (painful) open rotator cuff repair. Their practice highlights how protocols can be strikingly different between centres: continuous interscalene analgesia has been used in Auckland (population 1.5 million) since 2003, and is now the standard of care here for rotator cuff repair, which is in keeping with the nine identified randomised trials comparing continuous with single injection techniques for this surgery [5]. The move, where possible, from single injection blocks to continuous techniques was the main conclusion drawn from the evidence reviewed [5]. We would urge Drs Subash and Hilton to perform a prospective study in patients having rotator cuff repair at their institution, specifically questioning patients for pain during postoperative days one and two. If the analgesia were as good as suggested, this would contradict the aforementioned evidence. Further elaboration of their regional anaesthetic technique might then be warranted, which could be of great value to the anaesthetic community.