Periosteal block versus intravenous regional anesthesia for reduction of distal radius fractures: A randomized controlled trial.
Acad Emerg Med
; 29(10): 1213-1220, 2022 10.
Article
en En
| MEDLINE
| ID: mdl-35766126
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.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Fracturas del Radio
/
Anestesia de Conducción
Tipo de estudio:
Clinical_trials
Límite:
Humans
Idioma:
En
Revista:
Acad Emerg Med
Asunto de la revista:
MEDICINA DE EMERGENCIA
Año:
2022
Tipo del documento:
Article
País de afiliación:
Nueva Zelanda