Objective      To observe the clinical effects and safety of bilateral axillary brachial plexus block in microsurgery for bilateral upper limbs. Methods      In this randomized controlled trial

80 patients classified to ASA grade Ⅰ or Ⅱ physical status were randomly allocated to 2 groups

i.e.

general anesthesia and bilateral brachial plexus block

for upper limb microsurgery. Each group contained 40 patients. In brachial plexus group

bilateral axillary brachial plexus block was carried out under the instruction of Nerve Stimulator

while I

ntravenous-inhalation Combined Anesthesia was used in general anesthesia group. Vital signs were assessed before anesthesia (T

1

) and after anesthesia (T

2

)

as well as before surgery (T

3

) and after surgery (T

4

). Pain status was scored at 2

4

8 and 12 h after surgery. Adverse events as well as satisfaction in anesthesia and anesthesia fees were assessed. Results     In general anesthesia group

systolic pressure (BP) and heart rate (HR) were significantly lower at T1 versus at T4 (P0.05). At T4

they were significantly higher than brachial plexus group (P0.05). The VAS score of postoperative 2

4 and 8 h showed that patients in general anesthesia suffered more pain compared to patients in brachial plexus group (P0.05). However

the postoperative pain period was significantly longer in brachial plexus group than in general anesthesia group (P0.05). In addition

the cost of general anesthesia was significantly higher compared to brachial plexus group

associated with higher incidence of adverse events but less patient satisfaction (P0.05). Conclusion      Bilateral axillary brachial plexus block is suitable under the operation of bilateral upper limb microsurgery.