The role of multifocal regional blocks for pain control in polytrauma patients

Abstract

Purpose. To analyze the effectiveness and safety of the multifocal regional blocks within
blocking several anatomical segments in order to relieve pain in patients with polytrauma.
Material and methods. A retrospective study was carried out at the Republican Research
Center Of Emergency Medicine (RRCEM) in 2023 on 17 patients with polytrauma, who were
provided with multifocal regional blocks within blocking several anatomical segments in order to relieve pain. The primary results of the study included as follow: narcotic analgesics’
prescription and consumption, hemodynamic parameters. The secondary results of the study
included as follow: the length of duration on mechanical ventilation after surgery, the length
of stay in the intensive care unit (ICU) and the length of hospital stay.
Results. The requirements for narcotic analgesics, determined with morphine equivalent,
was 19.71±8.92 mg (95% CI: 15.12–24.29 mg) on the first day after surgery, 11.47±7.45 mg
(95% CI) on the second day (CI: 7.64–15.30 mg) and on the third day 10.00±8.48 mg (95%
CI: 5.64–14.36 mg) consequently, statistic data showed significant reduction by 42% on the
second day and 49% on the third day compared to the first day ( p<0.001). During our survey by performing multifocal regional blocks, we did not face any negative effects on hemodynamic parameters, which remained within normal values at all stages. The total duration
of mechanical ventilation after surgery till extubation was 9.1±9.2 hours (95% CI: 4.4–13.9).
The patient’s length of stay in the intensive care unit was 1.9±1.6 days (95% CI: 1.1–2.8). The
length of hospital stay was 11.0±6.0 days (95% CI: 7.9–14.1) definitely.
Conclusion. According to the results of this pilot study, it cannot be said with full of confidence that the use of multifocal regional blocks within blocking several anatomical segments
in patients with polytrauma is a fairly effective and safe method of pain management. It is
necessary to investigate further research on the use of multifocal regional blocks in patients
with polytrauma, including a larger number of patients and conducting a comparative analysis with other methods of pain management