The Influence of Preoperative Sympathetic Block or Regional Anesthesia on Postoperative Analgesic Use of Pain Scores After Upper Extremity Surgery:

Abstract

Objectives: This study evaluated the effects of sympathetic block and regional anesthetic block on postoperative pain and analgesic use in patients undergoing upper extremity surgery. Methods: In one trial, 34 subjects were randomly allocated to double blindedly receive an active [N = 19] or sham [N = 15] stellate ganglion block on the surgical side after induction of general anesthesia. Analgesic use was compared during the first 3 postoperative days. In another trial, 26 subjects received either general anesthesia [N = 14] or regional anesthesia [N = 12] by random assignment. Analgesic use and pain scores were compared for the first 3 postoperative days and at postoperative weeks 2 and 4. Results: The groups to be compared in each trial were similar with regard to age, gender, duration of intraoperative tourniquet inflation, and type of surgery performed. Subjects receiving regional anesthesia tended to use less postoperative analgesics during the first two postoperative days [P =. 08] than patients who underwent a general anesthetic but the difference was not statistically significant. These observations are discussed in light of present theories of neural sensitization and implications for clinical care.

KEYWORDS:

• Regional anesthesia
• hand surgery
• post-op pain
• analgesic
• sympathetic block