Pain Assessment in Patients Undergoing Upper Limb Orthopedic Surgery: A Retrospective Study

In upper limb orthopedic surgeries, two main anesthetic techniques are used: regional anesthesia (RA), more precisely brachial plexus block, and general anesthesia (GA). The objective of this study was to compare the two techniques by assessing postoperative pain using the NRS (Numerical Rating Scale), opioid consumption, and antiemetic consumption, to identify the differences and advantages of each method.

This retrospective observational study was conducted in the Orthopedics and Traumatology Clinic of SCJU Constanța. 82 patients with ASA I-III classification were included in the study, of which 43 received general anesthesia (GA) and 39 regional anesthesia (RA) via brachial plexus block, axillary approach. The GA group was treated according to a uniform general anesthesia protocol, while the RA group followed the same postoperative analgesia scheme. All included patients underwent surgical interventions in the distal arm, elbow, forearm, and hand RAea.

The NRS pain scores assessed at 2, 4, 6, and 12 hours postoperatively were significantly lower in the RA group compared to the GA group. Regarding opioid use, 66% of patients in the GA group required administration, while only 2.3% of patients in the RA group required them. No patients in the RA group received antiemetics, while 30% of patients in the GA group required this type of medication.

Regional anesthesia through brachial plexus block demonstrated superior benefits compared to general anesthesia, both in terms of reducing postoperative pain scores and in reducing the need for opioids and antiemetics.