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

Amir Nejati, Houman Teymourian, Leili Behrooz, Gholamreza Mohseni




Introduction: Pain is the most common complaint of patients referring to emergency department (ED). Considering
the importance of pain management in ED, this study aimed to investigate the efficacy and feasibility of
ultrasound-guided nerve blocks in this setting. Methods: 46 patients who came to the ED with injured extremities
were enrolled in the study and received either femoral, axillary or sciatic nerve block depending on their
site of injury (1.5 mg Bupivacaine per kg of patient’s weight). Patients were asked about their level of pain before
and after receiving the nerve block based on numerical rating scale. The difference between pre and post block
pain severity was measured. Both patients and physicians were asked about their satisfaction with the nerve
block in 5 tiered Likert scale. Results: 46 patients with the mean age of 37.5 § 12.5 years (8-82 years) received
ultrasound-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%) were
neutral and had no opinion (Likert scale 3), 1 (2.1%) was not satisfied (Likert scale 2), and 2 (4.3%) were highly
unsatisfied (Likert scale 1). There was no significant difference among the satisfaction scores within the three
block locations (p = 0.8). There was no significant difference in physicians level of satisfaction between the three
block locations either (p = 0.9). 1 (2.1%) case of agitation and tachycardia and 1 (2.1%) case of vomiting were
observed after the procedure. Conclusion: Ultrasound-guided nerve block of extremities is a safe and effective
method that can be used for pain management in the ED. It results in high levels of satisfaction among both
patients and physicians.


Nerve Block; Ultrasonography, Interventional; PainManagement; Emergency Service, Hospital


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DOI: http://dx.doi.org/10.22037/emergency.v5i1.12642

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