{
  "abstract": "Background and Aims Regional anaesthesia (RA) is crucial in battlefield surgery for effective analgesia and workload reduction. Ultrasound-guided supraclavicular brachial plexus block (SCBPB) is valuable in forward military hospitals, close to combat zones, where general anaesthesia is often less feasible.Methods We present 30 representative cases of upper limb combat injuries treated with ultrasound-guided SCBPB at a forward-positioned hospital (10–15 km from combat line). Patients were divided into two groups of 15: those receiving dexmedetomidine (DMM) and those without. Blocks used ropivacaine 150 mg, dexamethasone 4 mg, and DMM 1 μg/kg (in DMM group). Anaesthesia was administered within hours of evacuation. Data was recorded using a ‘Regional Anesthesia Card’ ( figure 1). Detailed medical data obtained is presented in the Attachment (table 1 - Summary Table).Results Effective surgical anaesthesia was achieved in most cases, avoiding general anaesthesia conversion. In the DMM group (n=15), mean onset time was 10.53 ± 1.82 min (7.3–14.4 min range). Postoperative analgesia averaged 802.67 ± 103.20 min (650–960 min), with mean time to first pain relief request 1272.00 ± 340.93 min. Bradycardia occurred in 6 patients (40%), hypotension in 2 (13.3%). In the non-DMM group (n=15), mean onset time was 13.56 ± 1.88 min (10.7–16.1 min range). Postoperative analgesia averaged 372.67 ± 83.45 min (240–550 min), with mean time to first pain relief request 721.33 ± 162.78 min ( figure 2). Bradycardia occurred in 2 patients (13.3%), hypotension in 3 (20%). Following surgical interventions, patients were safely transported to rear hospitals, with the performed block providing effective analgesia throughout transport. The technique significantly reduced anaesthesiology workload compared to general anaesthesia.Abstract EP201 Figure 1Gunshot wound to the right shoulder with a fracture of the humerusAbstract EP201 Table 1Example of regional anesthesia card to record the effectiveness of the blockadeAbstract EP201 Figure 2Comparison of efficacy of SCBPB with and without dexmedetomidineConclusions Ultrasound-guided SCBPB with adjuvants is safe, efficient, and well-suited for forward military medical settings. Dexmedetomidine significantly prolongs analgesia, facilitating surgical care and pain control during evacuation under combat conditions.",
  "authors": [
    {
      "affiliations": [
        "Anesthesiology Department and Intensive Care Unit, Vinnitsya Municipal Clinical Hospital, Vinnitsya, Ukraine"
      ],
      "name": "Papyshev Dmytro"
    }
  ],
  "title": "EP201 Ultrasound-guided supraclavicular brachial plexus block with adjuvants in combat-related upper limb injuries: a case series from a forward military hospital",
  "uid": "ba03961e-a4ca-58db-a1c6-2f03a7f57614"
}