Effect of ultrasound-guided brachial plexus block on perioperative pain management of total elbow arthroplasty

Background : Ultrasound-guided brachial plexus block (UGBB) makes it possible to block both lateral and medial aspects of the skin overlying the elbow, which are mainly innervated by C5 and T1 roots of brachial plexus, respectively. The effect of UGBB on perioperative pain relief in total elbow arthroplasty (TEA) was evaluated. Methods : Twenty-one patients scheduled to undergo TEA with general anesthesia from January 2009 to December 2010 were assigned to a group receiving UGBB (Block group, n=10) and a group receiving general anesthesia alone (General group, n=ll). Perioperative anesthetic dose and postoperative pain intensity were recorded. Statistical analysis was performed with Mann-Whitney's U-test, and P<0.05 was considered to be significant. Results : Median fentanyl doses during the operation in the Block group and General group were 100μg and 250μg, respectively (P<0.05). Numerical rating scale (NRS) in the Block group was significantly lower than that in the General group immediately after the operation (median value : Block group=0, General group=4). Although NRS in the two groups was not different from the night of the day of operation, no patient in the Block group needed supplementary opioids. Conclusions : Ultrasound-guided brachial plexus block in patients undergoing TEA reduces perioperative opioid consumption and wound pain in the early postoperative period.