How Personality Type Affects Pain and the Need for General Anesthesia in Patients Receiving an Arm Nerve Block for Wrist Fracture Surgery

NCT07450768 | Completed

• 1 other identifier: 2022-21/189
• Study Type: observational
• Target: 46
• Locations: 1 country
• Sites: 1

Brief Summary

This study looked at whether a person's emotional personality type affects how they experience pain and how well a regional anesthesia technique works during arm surgery. We studied patients who underwent wrist or upper arm surgery using an axillary nerve block (a type of regional anesthesia that numbs the arm). Before surgery, patients completed a questionnaire measuring their emotional temperament, including anxious, depressive, cyclothymic, irritable, and other personality traits. We found that patients with an anxious personality type were more likely to need conversion to general anesthesia during surgery. They also reported higher pain scores after surgery. Patients with depressive traits also experienced higher pain levels. In contrast, some other temperament types reported lower pain levels. These findings suggest that emotional characteristics may influence how patients respond to anesthesia and pain after surgery. Understanding a patient's temperament before surgery may help doctors better plan anesthesia, provide additional support when needed, and improve overall comfort and safety. This research supports a more personalized approach to anesthesia care, taking into account not only physical health but also psychological factors.

Conditions

Temperament; Trauma (Including Fractures)

Keywords

affective temperament; TEMPS-A; Axillary brachial plexus block; Conversion to general anesthesia; Postoperative pain

Outcome Measures

Primary Outcomes (1)

• Anesthesia Escalation (Sedation and/or General Anesthesia)

  Proportion of patients who required escalation beyond axillary brachial plexus block, defined as the need for additional intravenous sedation and/or conversion to general anesthesia due to inadequate surgical anesthesia or patient discomfort.

  Intraoperative period (from block performance until completion of surgery)

Secondary Outcomes (2)

• Postoperative Pain Intensity (VAS Score)

  Preoperative baseline, postoperative 3rd hour, 12th hour, and 24th hour

• Predictors of Anesthesia Escalation

  Intraoperative period

Study Arms (6)

Depressive Temperament Group

Patients classified as having a depressive affective temperament based on TEMPS-A questionnaire scoring. Procedure: Axillary Brachial Plexus Block Ultrasound-guided axillary brachial plexus block performed using 20 mL of 0.25% bupivacaine for surgical anesthesia of the upper extremity. Drug: Intravenous Sedation Supplemental intravenous sedation administered intraoperatively in cases of patient discomfort during regional anesthesia. Sedation was provided according to standard institutional practice. Procedure: General Anesthesia (if required) Conversion to general anesthesia when regional anesthesia with or without sedation was insufficient to maintain adequate surgical conditions. Block failure was defined as inability to complete the procedure under regional anesthesia alone.

Anxious Temperament Group

Patients classified as having an anxious affective temperament according to TEMPS-A assessment. Procedure: Axillary Brachial Plexus Block Ultrasound-guided axillary brachial plexus block performed using 20 mL of 0.25% bupivacaine for surgical anesthesia of the upper extremity. Drug: Intravenous Sedation Supplemental intravenous sedation administered intraoperatively in cases of patient discomfort during regional anesthesia. Sedation was provided according to standard institutional practice. Procedure: General Anesthesia (if required) Conversion to general anesthesia when regional anesthesia with or without sedation was insufficient to maintain adequate surgical conditions. Block failure was defined as inability to complete the procedure under regional anesthesia alone.

Cyclothymic Temperament Group

Patients identified with cyclothymic temperament characteristics using TEMPS-A. Procedure: Axillary Brachial Plexus Block Ultrasound-guided axillary brachial plexus block performed using 20 mL of 0.25% bupivacaine for surgical anesthesia of the upper extremity. Drug: Intravenous Sedation Supplemental intravenous sedation administered intraoperatively in cases of patient discomfort during regional anesthesia. Sedation was provided according to standard institutional practice. Procedure: General Anesthesia (if required) Conversion to general anesthesia when regional anesthesia with or without sedation was insufficient to maintain adequate surgical conditions. Block failure was defined as inability to complete the procedure under regional anesthesia alone.

Hyperthymic Temperament Group

Patients classified as hyperthymic temperament type based on questionnaire results. Procedure: Axillary Brachial Plexus Block Ultrasound-guided axillary brachial plexus block performed using 20 mL of 0.25% bupivacaine for surgical anesthesia of the upper extremity. Drug: Intravenous Sedation Supplemental intravenous sedation administered intraoperatively in cases of patient discomfort during regional anesthesia. Sedation was provided according to standard institutional practice. Procedure: General Anesthesia (if required) Conversion to general anesthesia when regional anesthesia with or without sedation was insufficient to maintain adequate surgical conditions. Block failure was defined as inability to complete the procedure under regional anesthesia alone.

Irritable Temperament Group

Patients identified as having irritable temperament features according to TEMPS-A scoring. Procedure: Axillary Brachial Plexus Block Ultrasound-guided axillary brachial plexus block performed using 20 mL of 0.25% bupivacaine for surgical anesthesia of the upper extremity. Drug: Intravenous Sedation Supplemental intravenous sedation administered intraoperatively in cases of patient discomfort during regional anesthesia. Sedation was provided according to standard institutional practice. Procedure: General Anesthesia (if required) Conversion to general anesthesia when regional anesthesia with or without sedation was insufficient to maintain adequate surgical conditions. Block failure was defined as inability to complete the procedure under regional anesthesia alone.

Non-Dominant Temperament Group

Patients who did not demonstrate dominance in any of the five primary temperament categories. Procedure: Axillary Brachial Plexus Block Ultrasound-guided axillary brachial plexus block performed using 20 mL of 0.25% bupivacaine for surgical anesthesia of the upper extremity. Drug: Intravenous Sedation Supplemental intravenous sedation administered intraoperatively in cases of patient discomfort during regional anesthesia. Sedation was provided according to standard institutional practice. Procedure: General Anesthesia (if required) Conversion to general anesthesia when regional anesthesia with or without sedation was insufficient to maintain adequate surgical conditions. Block failure was defined as inability to complete the procedure under regional anesthesia alone.

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The study population consists of adult patients undergoing elective upper extremity surgery at Kırşehir Ahi Evran University Training and Research Hospital, a tertiary academic medical center in Turkey. Participants were recruited from patients evaluated in the preoperative anesthesia outpatient clinic and scheduled to receive ultrasound-guided axillary brachial plexus block as the primary anesthetic technique.

You may qualify if:

• Age between 18 and 65 years
• Scheduled for elective upper extremity surgery requiring axillary brachial plexus block
• American Society of Anesthesiologists (ASA) physical status I-III
• Ability to understand and complete the TEMPS-A questionnaire
• Provision of written informed consent

You may not qualify if:

• Refusal to participate
• Contraindication to regional anesthesia (e.g., local infection at injection site, coagulopathy)
• Known allergy to local anesthetics (bupivacaine)
• Cognitive impairment or inability to complete the temperament questionnaire
• Severe psychiatric disorder requiring active treatment
• Incomplete perioperative data or missing VAS assessments

Sponsors & Collaborators

• Kirsehir Ahi Evran Universitesi: lead

Study Sites (1)

Ahi Evran University

Kırşehir, 40100, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Wounds and Injuries; Pain, Postoperative

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Target Duration: 1 Day
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Asssistant Professor

Study Record Dates

• First Submitted: March 1, 2026
• First Posted: March 5, 2026
• Study Start: March 15, 2023
• Primary Completion: March 15, 2024
• Study Completion: March 15, 2024
• Last Updated: March 5, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)