Pain Management and Opioid Use with Long-Acting Peripheral Nerve Blocks for Hand Surgery: A Descriptive Study.

Area of Science:

• Anesthesiology
• Regional Anesthesia
• Pain Management

Background:

• Peripheral nerve blocks (PNBs) offer regional pain relief with fewer side effects.
• Short-acting PNBs provide pain relief for less than 24 hours.
• Liposomal bupivacaine offers extended PNB duration up to 72 hours, potentially reducing opioid use.

Purpose of the Study:

• To investigate perioperative pain and opioid consumption in patients undergoing hand surgery with long-acting brachial plexus PNBs.
• To assess patient satisfaction with pain management following liposomal bupivacaine PNBs.

Main Methods:

• Retrospective review of 103 patients receiving liposomal bupivacaine brachial plexus PNBs for hand surgery (July 2020 - May 2023).
• Patients completed a 10-question survey on pain, symptoms, satisfaction, and analgesic use.
• Data analyzed for pain reduction, block duration, satisfaction scores, and opioid/NSAID usage.

Main Results:

• Significant pain reduction reported: from 7.9/10 pre-block to 1.6/10 perioperatively and 4.3/10 and 3.8/10 in early and later postoperative periods.
• Average nerve block duration was 2.2 days.
• High patient satisfaction (9.4/10), with 20.4% prescribed opioids and 41.7% using NSAIDs postoperatively.

Conclusions:

• Liposomal bupivacaine PNBs provide effective, long-lasting pain relief for hand surgery.
• These blocks significantly improve patient satisfaction and reduce the need for postoperative opioids.
• Long-acting PNBs show promise in enhancing recovery and decreasing reliance on opioid analgesics.