Pain Control and Satisfaction With Peripheral Nerve Blocks for Upper Extremity Surgery

Abstract

Background: Regional anesthesia (“block”) is an important component of upper extremity (UE) surgery pain control. However, little is known about patient experience related to perioperative opioid use. This study assessed patient-reported pain control and satisfaction with UE blocks and evaluated how opioid consumption impacted these outcomes before the block “wore off.” Methods: A postoperative phone survey was administered to patients who underwent outpatient UE surgery at a surgery center for more than 16 months. It assessed pain scores (scale 1-10), satisfaction with block duration (scale 1-5), duration until return of UE function, and opioid consumption. Analyses used Mann-Whitney U tests, Fisher exact tests, and bivariate and multivariable linear and ordered logistic regressions to understand relationships between opioid use and outcomes. Results: A total of 509 patients (61%) completed the survey, and 441 (88%) were satisfied with block duration. Initial and final pain scores were significantly higher in patients who took opioids prior to the block wearing off (6 and 4.5, P = .04 and 3.5 and 2, P = .002, respectively). Although satisfaction with block duration was not different in group comparisons (ie, patients who premedicated vs those who did not), in a multivariable analysis, patients who premedicated with opioids had 78% increased odds of reporting the highest level of satisfaction compared with the lower 4 levels ( P = .03). Conclusions: Upper extremity blocks are associated with high overall patient satisfaction and postsurgical pain control. Premedicating before the block wears off may increase patient satisfaction with block duration even if pain is not notably impacted.

Anaesthesia practice, quality indices including all‐cause 30‐day mortality associate to wrist fracture repositioning and surgery in Sweden: A perioperative register‐based study 2018–2021

“…There is a common use of RA with or without GA in patients with wrist fractures. Several factors may contribute to the use of RA as the increasing availability of ultra‐sound devices and an increased interest in ultra‐sound guided blocks in recent years The opportunity to improve early recovery after upper‐extremity surgery using peripheral blocks has attracted increasing interest 12,13 . The shorter RR stay seen in the RA group is thus not surprising, as the technique reduces early pain and emesis.…”