Efficacy of ultrasound-guided regional anaesthesia in postoperative pain management: a prospective study

Background: Opioid use and its associated side effects are frequently increased by inadequate postoperative pain management. Ultrasound-guided regional anaesthesia (UGRA) is increasingly incorporated into multimodal analgesic protocols to improve perioperative pain management while limiting systemic opioid exposure. Aim: To determine whether UGRA lessens opioid use and postoperative pain in patients having elective surgery. Methodology: In this prospective study, 100 patients (ASA I–III) scheduled for elective orthopedic, abdominal, or spine surgery were assigned to receive either UGRA combined with general anaesthesia and standard postoperative analgesia (n=50) or general anaesthesia with standard postoperative analgesia alone (n=50). The Numerical Rating Scale was used to assess pain at 2, 6, 12, and 24 hours after surgery. Time to initial rescue analgesia, incidence of postoperative nausea and vomiting (PONV), block-related complications, 24-hour opioid intake measured in morphine milligram equivalents (MME), and the relationship between 24-hour pain levels and opioid use were secondary outcomes. Results: At every time point, the UGRA group's pain ratings were considerably reduced (p < 0.001). There was a decrease in 24-hour opioid consumption (14.40 ± 3.36 vs. 40.62 ± 7.04 MME; p<0.001) and a longer time to first rescue analgesia (8.22 ± 1.67 vs. 4.94 ± 1.68 hours; p < 0.001). PONV occurred less frequently (8% vs 20%; p=0.048). Pain intensity at 24 hours correlated strongly with opioid consumption (r = 0.80; p < 0.001). Conclusion: UGRA was associated with improved early postoperative analgesia, significant opioid reduction, prolonged analgesic duration, and lower PONV incidence.