title: Comparison of Ultrasound-Guided Axillary Brachial Plexus Block Properties in Diabetic and Nondiabetic Patients: A Prospective Observational Study.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Therapeutic II.
authors.affiliation: Department of Anesthesiology, Division of Hand, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey. Electronic address: aysusalviz@gmail.com.
authors.forename: Emine Aysu
authors.initials: EA
authors.lastname: Salviz
authors.affiliation: Department of Anesthesiology, Division of Hand, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Sukru
authors.initials: S
authors.lastname: Onbasi
authors.affiliation: Department of Anesthesiology, Division of Hand, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Anil
authors.initials: A
authors.lastname: Ozonur
authors.affiliation: Department of Anesthesiology, Division of Hand, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Mukadder
authors.initials: M
authors.lastname: Orhan-Sungur
authors.affiliation: Department of Plastic and Reconstructive Surgery, Division of Hand, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Berkoz
authors.affiliation: Department of Anesthesiology, Division of Hand, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Kamil Mehmet
authors.initials: KM
authors.lastname: Tugrul
mesh_terms: D000328:Adult; D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage; D001365:Axilla / Q000000981:diagnostic imaging; D065527:Brachial Plexus Block / Q000379:methods*; D003924:Diabetes Mellitus, Type 2; D003929:Diabetic Neuropathies; D005260:Female; D005542:Forearm / Q000601:surgery; D006225:Hand / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D014463:Ultrasonography
chemical_list: D000779:Anesthetics, Local
keywords: Diabetes mellitus; axillary brachial plexus blocks; block duration; postoperative analgesia; time until first pain