Blast-related Regional Anaesthesia and Peripheral nerVe Injury Evaluation

This randomized study will examine whether ultrasound-guided regional anaesthesia (a nerve block) contributes to new or worsening peripheral nerve problems after blast-related limb trauma. Blast injuries themselves can damage nerves, making it difficult to determine whether later numbness, weakness, or neuropathic pain is caused by the injury, surgery, or the nerve block. Adults with blast-related upper- or lower-limb trauma who need pain treatment will be randomly assigned to one of two standard pain-management strategies: regional anaesthesia plus multimodal analgesia, or multimodal systemic analgesia without a planned nerve block. All participants will receive appropriate rescue pain treatment if needed. Neurological function will be documented before treatment and reassessed during hospital care and follow-up. The main outcome is a new or worsened peripheral nerve deficit 30 days after treatment. The study will also assess pain relief, opioid use, function, neuropathic pain, and safety events up to 6 months.