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

Purpose: 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.