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Periosteal block versus intravenous regional anesthesia for reduction of distal radius fractures: A randomized controlled trial.
- Source :
- Academic Emergency Medicine; Oct2022, Vol. 29 Issue 10, p1213-1220, 8p
- Publication Year :
- 2022
-
Abstract
- Objective: We compare periosteal block and intravenous regional anesthesia (IVRA) as anesthetic techniques for reduction of distal radius fractures when performed by emergency department (ED) clinicians following brief training. Methods: This was a single‐center, nonblinded randomized controlled trial of a convenience sample of patients presenting with distal radius fractures requiring closed reduction. Primary outcome measure was patient reported fracture reduction pain score, rated on a 100‐mm visual analog scale. Secondary outcomes included adjunct pain medication use, ED length of stay, remanipulation rates, participant satisfaction, clinician assessed efficacy, and clinician‐assessed ease of the procedure. Results: Eighty‐one patients were randomized to receive IVRA (n = 41) or periosteal block (N = 40). Reduction pain scores were not normally distributed. Median (25th–75th percentile) pain scores in participants assigned to IVRA and periosteal block were 5 (1–27.5) and 26 (8.5–63) mm, respectively, (p = 0.007). Use of adjunct medications during reduction was higher for the periosteal block group compared with IVRA (57.5% vs. 22.5%, p = 0.003). Remanipulation rates were 17.5% for periosteal block versus 7.5% for IVRA (p = 0.31). There was no difference in length of stay, patient satisfaction, or clinician's assessed ease of the anesthetic technique. There was a difference in clinician's assessment of efficacy between groups, with IVRA described as "extremely effective" by 65% and periosteal block described as "extremely effective" by 25% (p = 0.003). Conclusions: When performed by a diverse group of ED clinicians periosteal block provided inferior analgesia to IVRA but may provide an alternative when IVRA cannot be performed. [ABSTRACT FROM AUTHOR]
- Subjects :
- PREVENTION of surgical complications
INTRAVENOUS anesthesia
LENGTH of stay in hospitals
PAIN
HOSPITAL emergency services
PAIN measurement
NONSTEROIDAL anti-inflammatory agents
NERVE block
SURGICAL complications
PATIENT satisfaction
TREATMENT effectiveness
RANDOMIZED controlled trials
COMPARATIVE studies
FRACTURE fixation
DESCRIPTIVE statistics
STATISTICAL sampling
DISTAL radius fractures
CONDUCTION anesthesia
Subjects
Details
- Language :
- English
- ISSN :
- 10696563
- Volume :
- 29
- Issue :
- 10
- Database :
- Complementary Index
- Journal :
- Academic Emergency Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 159612419
- Full Text :
- https://doi.org/10.1111/acem.14555