Prospective Evaluation of the Effectiveness of Brachial Plexus Nerve Block During the Perioperative Period in Long-Term Opioid Users Undergoing Upper Extremity Surgery – A Case Series

Daniel Huettner,1 Yue Qiu,1 Bedda L Rosario,2 Steven Orebaugh1 1Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA; 2Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USACorrespondence: Steven Orebaugh, Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA, Email [email protected]: This study examined whether chronic opioid use reduces the effectiveness of brachial plexus block in patients undergoing upper extremity surgery.Patients and Methods: Patients undergoing surgery with brachial plexus blocks were divided into two groups: opioid-dependent (daily opioid use for ≥ 1 month) and control (no opioid use for ≥ 3 months). Pain scores and opioid use were recorded over 72 hours postoperatively.Results: Forty-six patients were included (23 opioid-dependent and 23 control). The median (IQR) NRS scores upon PACU arrival were 0 (0– 0) in the control group and 0 (0– 5) in the opioid group (p=0.0101). The duration of the nerve block was shorter in opioid-dependent patients (14 versus 22 hours; p=0.0035).Conclusion: Chronic opioid users experienced shorter brachial plexus block duration and more postoperative pain after being discharged home.Keywords: anesthesia, opiates, recovery, chronic pain