Comparison of Ultrasound-Guided Axillary Brachial Plexus Block Properties in Diabetic and Nondiabetic Patients: A Prospective Observational Study

Emine Aysu Salviz, Sukru Onbasi, Anil Ozonur, Mukadder Orhan-Sungur, Omer Berkoz, Kamil Mehmet Tugrul

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Purpose Patients with diabetes mellitus (DM) type 2 may have subclinical peripheral nerve neuropathy. We performed this study to compare the differences in duration of axillary brachial plexus blocks in patients with type 2 DM and without DM (NODM). Our hypothesis was that the sensory block duration would be prolonged in patients with DM. Methods A total of 71 patients who were scheduled for elective forearm and/or hand surgery were enrolled in this study. Before surgery, they received ultrasound-guided axillary brachial plexus blocks with a mixture of 10 mL lidocaine 2% and 20 mL bupivacaine 0.5%. After surgery, all patients received 1 g paracetamol every 6 hours as needed. The primary end point was sensory block duration. Secondary end points were motor block duration, time until first pain (numeric rating scale [NRS] 4 or greater), highest NRS pain scores, and rescue analgesic consumption (NRS 4 or greater) through the first 2 postoperative days. Results In all, 67 patients completed the study: 22 in the DM group and 45 in the NODM group. Sensory and motor block durations were longer in the DM group than in the NODM group (mean [range], 773.5 [479–1155] vs 375 [113–900] minutes, and 523 [205–955] vs 300 [110–680] minutes). Time until first pain was 855 (590–1,285) minutes in the DM group and 500 (200–990) minutes in the NODM group. The highest NRS scores were also significantly lower in the DM group at 6 and 12 hours. Paracetamol consumption was lower in the DM group through the first 2 postoperative days. Conclusions The presence of DM was associated with longer duration of the sensory block after axillary brachial plexus block. Type of study/level of evidence Therapeutic II.

Original languageEnglish
Pages (from-to)190-197
Number of pages8
JournalJournal of Hand Surgery
Volume42
Issue number3
DOIs
StatePublished - Mar 1 2017

Keywords

  • axillary brachial plexus blocks
  • block duration
  • Diabetes mellitus
  • postoperative analgesia
  • time until first pain

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