Comparison of Ultrasound-Guided Axillary Brachial Plexus Block Properties in Diabetic and Nondiabetic Patients: A Prospective Observational Study
| Autor: | Mukadder Orhan-Sungur, Kamil Mehmet Tugrul, Anil Ozonur, Emine Aysu Salviz, Ömer Berköz, Sukru Onbasi |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Lidocaine Analgesic 03 medical and health sciences 0302 clinical medicine Diabetic Neuropathies Forearm 030202 anesthesiology Diabetes mellitus Clinical endpoint Humans Medicine Orthopedics and Sports Medicine Prospective Studies Anesthetics Local Aged Ultrasonography Bupivacaine business.industry Hand surgery Middle Aged Hand medicine.disease Brachial Plexus Block Surgery medicine.anatomical_structure Diabetes Mellitus Type 2 Anesthesia Axilla Female business Brachial plexus 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | The Journal of Hand Surgery. 42:190-197 |
| ISSN: | 0363-5023 |
| DOI: | 10.1016/j.jhsa.2017.01.009 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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