Axillary Block Properties in Diabetic Patients
Condition: Diabetes Mellitus; Nerve Block Duration; Pain, Postoperative
MeSH terms: Diabetes Mellitus; Pain, Postoperative
Study type: Observational

Summary: 
      Background and objectives: The investigators performed this study to explore whether the
      presence of diabetes mellitus (DM) would affect the outcomes of axillary brachial plexus
      blocks (ABPBs) in patients undergoing elective forearm and/or hand surgery. The primary
      hypothesis was that the sensory block duration would be delayed in diabetic patients.

      Methods: After obtaining ethics committee approval and written informed consent, 71 patients
      were enrolled to the study. Diabetic patients were included in Group DM and non-diabetics
      were included in Group NODM. All received ultrasound-guided ABPBs with the mixture of 10 mL
      lidocaine 2% and 20 mL bupivacaine 0.5%. Our primary outcome was sensory block duration, and
      secondary outcomes were sensory and motor block onset times, motor block duration,
      time-to-first-pain (numeric rating scale (NRS) ≥4), postoperative NRS scores and rescue
      analgesic consumption (NRS) ≥4) through the postoperative first 2 days. All outcomes were
      assessed by a blinded investigators.
    

Detailed description: 
      Background and objectives: The impact of diabetes mellitus (DM) on the practice of peripheral
      nerve block anesthesia was mostly investigated in animal researches, and effects on human
      models are required to be clarified. The investigators performed this study to explore
      whether the presence of DM would affect the outcomes of axillary brachial plexus blocks
      (ABPBs) in patients undergoing elective forearm and/or hand surgery. The primary hypothesis
      was that the sensory block duration would be delayed in diabetic patients.

      Methods: After obtaining ethics committee approval and written informed consent, 71 patients
      with American Society of Anesthesiologists (ASA) physical status I-III and aged between 40
      and 75 years were enrolled to the study. Diabetic patients were included in Group DM and
      non-diabetics were included in Group NODM. All received ultrasound-guided ABPBs with the
      mixture of 10 mL lidocaine 2% and 20 mL bupivacaine 0.5%. Postoperatively, patients were
      administered paracetamol as rescue analgesics, if numeric rating scale (NRS) was ≥4. Our
      primary outcome was sensory block duration, and secondary outcomes were sensory and motor
      block onset times, motor block duration, time-to-first-pain (numeric rating scale (NRS) ≥4),
      postoperative NRS scores, and rescue analgesic consumption (NRS) ≥4) through the
      postoperative first 2 days. All outcomes were assessed by a blinded investigators.
    

Intervention name(s): Axillary Brachial Plexus Blocks
Intervention type(s): Drug
Intervention description(s): All patients received ultrasound-guided axillary brachial plexus block (ABPBs) with the mixture of 10 mL lidocaine 2% and 20 mL bupivacaine 0.5%.
Other intervention name(s): ABPBs
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Patients scheduled for elective forearm and/or hand surgery
      
Keywords: Diabetes mellitus; Axillary brachial plexus block; Block duration; Time-to-first pain; Postoperative analgesia