PT  - JOURNAL ARTICLE
AU  - Shuai Tang
AU  - Jin Wang
AU  - Yi Tian
AU  - Xu Li
AU  - Qiuju Cui
AU  - Mei Xu
AU  - Xiaojun Song
AU  - Yuehong Zheng
AU  - Hongbo Yang
AU  - Chao Ma
AU  - Lujing Zhan
AU  - Chaonan Zhu
AU  - Yuelun Zhang
AU  - Min Yao
AU  - Yuguang Huang
TI  - Sex-dependent prolongation of sciatic nerve blockade in diabetes patients: a prospective cohort study
AID  - 10.1136/rapm-2019-100609
DP  - 2019 Sep 01
TA  - Regional Anesthesia & Pain Medicine
PG  - 860--865
VI  - 44
IP  - 9
4099  - http://rapm.bmj.com/content/44/9/860.short
4100  - http://rapm.bmj.com/content/44/9/860.full
SO  - Reg Anesth Pain Med2019 Sep 01; 44
AB  - Introduction Diabetes may affect the duration of nerve block after regional anesthesia. This study aimed to compare the durations of sensory and motor block in diabetes versus non-diabetes patients after lower limb nerve block and delineate any sex-based differences in the duration of sensory and motor blocks of both diabetes and non-diabetes patients.Methods This prospective single-blinded cohort study recruited 86 patients who underwent unilateral lower extremity surgery; 52 patients were non-diabetic and 34 were diabetic. Each patient received an ultrasound-guided nerve stimulator-assisted subgluteal sciatic nerve block with 0.75% ropivacaine. Duration of sensory block was assessed with the Semmes-Weinstein monofilament test, and duration of motor block was assessed with dorsal and plantar flexion of the foot.Results The sensory and motor block durations of diabetes patients were significantly prolonged versus non-diabetes patients (19.8±6.0 hours vs 15.6±5.1 hours; p<0.05) and (19.5±8.1 hours vs 14.8±5.7 hours, p=0.005), respectively. The durations of sensory and motor block were comparable between male diabetes and non-diabetes patients, but they were significantly longer in female diabetes patients. Multiple regression analysis further revealed that, after adjustment for age and preoperative sensory threshold, diabetes, fasting plasma glucose and HbA1c levels were significantly associated with sensory and motor blocks. Sex analysis showed the association was only present in female diabetes patients, not male diabetes patients.Conclusion The durations of sensory and motor block are significantly prolonged after subgluteal sciatic nerve block in diabetes patients. Furthermore, the prolonged nerve blockade is present only in diabetes women, not diabetes men.Trial registration number NCT02482831.