This observational study aims to determine the incidence and clinical characteristics of rebound-breakthrough pain after ultrasound-guided brachial plexus block in adult patients with type 2 diabetes mellitus. Adult patients undergoing elective upper-extremity surgery are divided into a type 2 diabetes group and a non-diabetic control group. Baseline clinical data and pain-related outcomes are collected after nerve block. This work may provide evidence for optimizing perioperative pain management for diabetic patients receiving brachial plexus block.
Aged 18 years or older
Undergoing elective upper-extremity surgery
Planned for ultrasound-guided brachial plexus block with 0.375% ropivacaine
Able to cooperate with pain assessment and follow-up within 48 hours after block
Allergy or contraindication to amide-type local anesthetics
Pre-existing peripheral neuropathy of the affected upper limb
Chronic regular use of opioids before surgery
Coagulopathy or infection at the block puncture site
Adult patients receiving ultrasound-guided brachial plexus block for elective upper-extremity surgery. Subjects are divided into two cohorts: patients with type 2 diabetes mellitus and non-diabetic patients. Routine clinical anesthesia management is adopted without experimental interventions.
Cohort
Cross-sectional
Not listed
Incidence of postoperative rebound-breakthrough pain
Proportion of participants developing rebound-breakthrough pain within 48 hours after brachial plexus block.Rebound-breakthrough pain after peripheral nerve block is characterized by sudden severe pain (NRS ≥ 7) occurring within 24 hours after block resolution. It is typically burning in nature, may occur at rest or during movement, lasts more than 2 hours, and most frequently develops 12-24 hours postoperatively.
Within 48 hours after brachial plexus block
Peak numerical rating scale (NRS, 0-10) score during each rebound-breakthrough pain episode. Higher score indicates more severe pain.
Onset time of first rebound-breakthrough pain
Time interval from completion of brachial plexus block to the first occurrence of rebound-breakthrough pain.
Frequency of rebound-breakthrough pain episodes
Total number of rebound-breakthrough pain episodes within 48 hours after brachial plexus block.
Duration of each rebound-breakthrough pain episode
Duration of each rebound-breakthrough pain episode that occurs within 48 hours after brachial plexus block.
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