The Efficacy of Brachial Plexus Block in Diabetic Patients: A Prospective Study

Abstract

Background Diabetes mellitus is a systemic disease that affects peripheral nerves. The use of regional anaesthesia in diabetic patients undergoing surgery can be unpredictable. We investigated the efficacy of brachial plexus block (BPB) in diabetic patients compared to nondiabetic individuals. Methods Four hundred and six patients were included. Forty-six patients were diabetic: 20 with type 1, 22 with type 2 and four with diet-controlled diabetes. A mixture of 0.5% bupivacaine and 1% prilocaine was used. Postoperative proximal and distal, motor and sensory functions were assessed. Motor function was assessed using the Medical Research Council grading system. Sensory function was assessed using a graded scale. Results In diabetic patients, the BPB was as efficient for proximal motor ( p = 0.25) and sensory ( p = 0.33) blocks as it was in nondiabetic patients. There was a significant difference in the efficacy of the block distally between diabetic and nondiabetic patients in both motor ( p = 0.007) and sensory function ( p = 0.001). The efficacy of the BPB was poorer in diabetic patients. Conclusions A BPB can be used efficiently for shoulder surgery in diabetic patients. For distal surgery, surgeons and anaesthetists should be prepared to reinforce the block or use general anaesthesia.