{
  "abstract": "Background and Aims Peripheral nerve blocks (PNBs) offer significant benefits for perioperative analgesia, yet their use may vary due to implicit bias, institutional norms, or logistical constraints. These disparities raise ethical concerns, particularly regarding patient autonomy, justice, and equitable access. This audit aims to evaluate patterns of PNB utilisation across patient demographics, examine consent practices, and assess ethical considerations in regional anaesthesia delivery.Methods Institutional ethics approval will be sought prior to data collection. A retrospective audit will be conducted at a tertiary teaching hospital, reviewing medical records from a 12–18-month period for adult patients undergoing limb surgeries amenable to PNBs. Data Collection: Quantitative Component; 1. Patient demographics (age, gender, language, ASA status) 2. Surgical details (elective/emergency, type of procedure) 3. PNB use (yes/no, type of block) 4. Consent documentation (written, verbal, risks/alternatives, clinician role) 5. Outcomes (pain scores, opioid use, complications) Qualitative Component: 1. Content analysis of anaesthesia records and consent forms 2. Thematic review of how information is recorded regarding decision-making, patient understanding, and block rationale Ethical Framework: Findings will be interpreted using the principles of biomedical ethics: − Justice: Assessing disparities in block access − Autonomy: Evaluating quality and timing of consent − Beneficence & Non-maleficence: Balancing effective pain relief with safety and informed choiceResults We anticipate identifying variations in PNB utilisation and consent quality linked to non-clinical factors such as age, gender, and urgency of surgery. Qualitative analysis of documentation is expected to reveal institutional patterns and areas for ethical improvement. These insights will support more ethically sound and equitable anaesthesia practices.Conclusions This audit will offer a comprehensive evaluation of how regional anaesthesia is delivered through both clinical and ethical lenses. Findings will inform improvements in patient communication, equity in access to PNBs, and standardisation of consent processes aligned with ESRA recommendations.",
  "authors": [
    {
      "affiliations": [
        "Anaesthesiology, Aga Khan University, Karachi, Pakistan"
      ],
      "name": "Robyna Irshad Khan"
    },
    {
      "affiliations": [
        "Pain Nurse, Aga Khan University, Karachi, Pakistan"
      ],
      "name": "Rozina Kerai"
    }
  ],
  "title": "P178 Equity, consent, and clinical decision-making in regional anaesthesia: a retrospective audit on the use of peripheral nerve blocks across patient populations",
  "uid": "d223cd0c-01b0-5779-8a0a-9f0ee1e4a800"
}