Emergency (Dec 2016)

Pain Management via Ultrasound-guided Nerve Block in Emergency Department; a Case Series Study

  • Amir Nejati,
  • Houman Teymourian,
  • Leili Behrooz,
  • Gholamreza Mohseni

DOI
https://doi.org/10.22037/emergency.v5i1.12642
Journal volume & issue
Vol. 5, no. 1
pp. e12 – e12

Abstract

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Introduction: Pain is the most common complaint of patients referring to emergency department (ED). Consideringthe importance of pain management in ED, this study aimed to investigate the efficacy and feasibility ofultrasound-guided nerve blocks in this setting. Methods: 46 patients who came to the ED with injured extremitieswere enrolled in the study and received either femoral, axillary or sciatic nerve block depending on theirsite of injury (1.5 mg Bupivacaine per kg of patient’s weight). Patients were asked about their level of pain beforeand after receiving the nerve block based on numerical rating scale. The difference between pre and post blockpain severity was measured. Both patients and physicians were asked about their satisfaction with the nerveblock in 5 tiered Likert scale. Results: 46 patients with the mean age of 37.5 § 12.5 years (8-82 years) receivedultrasound-guided nerve block (84.8% male). 6 Sciatic, 25 axillary, and 15 femoral nerve blocks were performed.Mean pain severity on NRS score at the time of admission was 8.1 § 1.4, which reduced to 2.04 § 2.06 after block.25 (54.3%) patients were highly satisfied (Likert scale 5), 15 (32.6%) were satisfied (Likert scale 4), 3 (6.5%) wereneutral and had no opinion (Likert scale 3), 1 (2.1%) was not satisfied (Likert scale 2), and 2 (4.3%) were highlyunsatisfied (Likert scale 1). There was no significant difference among the satisfaction scores within the threeblock locations (p = 0.8). There was no significant difference in physicians level of satisfaction between the threeblock locations either (p = 0.9). 1 (2.1%) case of agitation and tachycardia and 1 (2.1%) case of vomiting wereobserved after the procedure. Conclusion: Ultrasound-guided nerve block of extremities is a safe and effectivemethod that can be used for pain management in the ED. It results in high levels of satisfaction among bothpatients and physicians.

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