Brachial Plexus Blockade Causes Subclinical Neuropathy: A Prospective Observational Study.

Area of Science:

• Neurology
• Anesthesiology
• Hand Surgery

Background:

• Assessing subclinical sensory changes after brachial plexus blocks for hand surgery.
• Utilizing Semmes-Weinstein monofilament testing to detect subtle sensory alterations.
• Hypothesizing postoperative subclinical neuropathy in patients receiving brachial plexus nerve blocks.

Purpose of the Study:

• To determine subclinical changes in hand sensation following brachial plexus blocks.
• To compare sensory outcomes between brachial plexus block and general anesthesia groups.
• To evaluate the incidence of postoperative neuropathy detected by monofilament testing.

Main Methods:

• Prospective enrollment of 115 adult hand surgery patients.
• Exclusion of patients with preoperative nerve deficits or nerve-related procedures.
• Comparison of Semmes-Weinstein monofilament testing scores preoperatively and postoperatively (mean 11 days) between block and general anesthesia groups.

Main Results:

• No clinically significant neurologic complications were reported in either group.
• A statistically significant decrease in postoperative sensation was observed in the operated block hand compared to the nonoperated hand.
• A non-statistically significant decrease in sensation was noted in the operated block hand versus the operated general anesthesia hand.

Conclusions:

• Brachial plexus blockade leads to subtle, subclinical sensory decreases at short-term follow-up.
• These sensory changes are not associated with clinically relevant neurological manifestations.
• Semmes-Weinstein monofilament testing can detect these subclinical effects.