Circumferential periosteal block versus hematoma block for the reduction of distal radius and ulna fractures: a randomized controlled trial

Purpose To assess the analgesic efficacy of the circumferential periosteal block (CPB) and compare it with the conventional fracture hematoma block (HB). Methods This study was a prospective single-center randomized controlled trial performed in a national orthopedic hospital. Fifty patients with di...

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Bibliographic Details
Published in:European journal of trauma and emergency surgery (Munich : 2007) 2023-02, Vol.49 (1), p.107-113
Main Authors: Lari, Ali, Jarragh, Ali, Alherz, Mohammad, Nouri, Abdullah, Behbehani, Mousa, Alnusif, Naser
Format: Article
Language:English
Subjects:
Analgesics
Anesthesia, Local - adverse effects
Clinical trials
Critical Care Medicine
Emergency medical care
Emergency Medicine
Fractures
Hematoma
Humans
Intensive
Medicine
Medicine & Public Health
Original
Original Article
Orthopedics
Pain - etiology
Prospective Studies
Radius
Radius Fractures - surgery
Regional anesthesia
Sports Medicine
Surgery
Surgical Orthopedics
Traumatic Surgery
Ulna Fractures - surgery
Wrist Fractures
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Summary:Purpose To assess the analgesic efficacy of the circumferential periosteal block (CPB) and compare it with the conventional fracture hematoma block (HB). Methods This study was a prospective single-center randomized controlled trial performed in a national orthopedic hospital. Fifty patients with displaced distal radius (with or without concomitant ulna) fractures requiring reduction were randomized to receive either CPB or HB prior to the reduction. Pain was sequentially measured using the visual analogue scale (VAS) across three stages; before administration of local anesthesia (baseline), during administration (injection) and during manipulation and immobilization (manipulation). Further, the effect of demographic factors on the severity of pain was analyzed in multivariate regression. Finally, complications and end outcomes were compared across both techniques. Results Patients receiving CPB experienced significantly less pain scores during manipulation (VAS = 0.64) compared with HB (VAS = 2.44) ( p  =  
ISSN:1863-9933
1863-9941
DOI:10.1007/s00068-022-02078-8