1887
Volume 2020, Issue 2
  • ISSN: 1999-7086
  • EISSN: 1999-7094

Abstract

Distal radius fractures, the most prevalent of all fracture types, are often associated with severe pain and discomfort and treated with closed reduction and splinting. This study aimed to compare ultrasound-guided supracondylar radial nerve block with procedural sedation for the treatment of distal radius fractures in the emergency department. Patients with isolated distal radius fractures and limited displacement who met the inclusion criteria were randomly divided into two groups, an ultrasound-guided nerve block group and a procedural sedation group, which were compared in terms of managing patients with distal radius fractures. The number of patients in each group was 27. The duration of the procedure was significantly shorter in the nerve block group than in the ketamine group ( < 0.001). Physician and patient satisfaction were determined according to the unipolar Likert scale and unlike for patients (0.001), no significant difference was noted between the two groups for the physicians ( = 0.619). Unlike nerve block, emergence reactions ( = 0.038) and vomiting ( = 0.009) occurred in the ketamine intervention. Ultrasound-guided supracondylar radial nerve block can be prescribed as an alternative method in minimal or non-displaced distal radius fractures instead of IV sedation due to fewer side effects and a shorter procedural duration.

Loading

Article metrics loading...

/content/journals/10.5339/jemtac.2020.14
2021-01-21
2024-03-28
Loading full text...

Full text loading...

/deliver/fulltext/jemtac/2020/2/jemtac.2020.14.html?itemId=/content/journals/10.5339/jemtac.2020.14&mimeType=html&fmt=ahah

References

  1. Tageldin ME, Alrashid M, Khoriati A, Gadikoppula S, Atkinson HD. Periosteal nerve blocks for distal radius and ulna fracture manipulation—the technique and early results. J Orthop Surg Res. 2015; 10:(1):134.
    [Google Scholar]
  2. Myderrizi N, Mema B. The hematoma block an effective alternative for fracture reduction in distal radius fractures. Med Arch. 2011; 65:(4):239–42.
    [Google Scholar]
  3. Aydin AA, Bilge S, Kaya M, Aydin G, Cinar O. Novel technique in ED: supracondylar ultrasound-guided nerve block for reduction of distal radius fractures. Am J Emerg Med. 2016; 34:(5):912–3.
    [Google Scholar]
  4. Handoll HH, Madhok R, Dodds C. Anaesthesia for treating distal radial fracture in adults. Cochrane Database Syst Rev. 2002; 3:(3):CD003320.
    [Google Scholar]
  5. Wu JJ, Lollo L, Grabinsky A. Regional anesthesia in trauma medicine. Anesthesiol Res Pract. 2011; 2011::713281.
    [Google Scholar]
  6. Sohoni A, et al. Focus on: ultrasound-guided forearm nerve blocks ACEP news October 2011.
    [Google Scholar]
  7. Mutty CE, Jensen EJ, Manka MA, Anders MJ, Bone LB. Femoral nerve block for diaphyseal and distal femoral fractures in the emergency department. Bone Joint Surg. 2007; 89:(12):2599–603.
    [Google Scholar]
  8. Griffin J, Nicholls B. Ultrasound in regional anaesthesia. Anaesthesia. 2010; 65:;Suppl 1:1–12.
    [Google Scholar]
  9. Marhofer P, Fritsch GJSoA. Safe performance of peripheral regional anaesthesia: the significance of ultrasound guidance. Anaesthesia. 2017; 72:(4):431–4.
    [Google Scholar]
  10. Sehmbi H, Madjdpour C, Shah UJ, Chin KJ. Ultrasound guided distal peripheral nerve block of the upper limb: A technical review. J Anaesthesiol Clin Pharmacol. 2015; 31:(3):296–307.
    [Google Scholar]
  11. Fredrickson MJ, Price DJ. Analgesic effectiveness of ropivacaine 0.2% vs 0.4% via an ultrasound-guided C5–6 root/superior trunk perineural ambulatory catheter. Br J Anaesth. 2009; 103:(3):434–9.
    [Google Scholar]
  12. Fredrickson MJ, Ting FS, Chinchanwala S, Boland MR. Concomitant infraclavicular plus distal median, radial, and ulnar nerve blockade accelerates upper extremity anaesthesia and improves block consistency compared with infraclavicular block alone. Br J Anaesth. 2011; 107:(2):236–42.
    [Google Scholar]
  13. Stone MB, Wang R, Price DD. Ultrasound-guided supraclavicular brachial plexus nerve block vs procedural sedation for the treatment of upper extremity emergencies. Am J Emerg Med. 2008; 26:(6):706–10.
    [Google Scholar]
  14. Mittal R, Vermani E. Femoral nerve blocks in fractures of femur: variation in the current UK practice and a review of the literature. Emerg Med J. 2014; 31:(2):143–7.
    [Google Scholar]
  15. Charan J, Biswas T. How to calculate sample size for different study designs in medical research? Indian J Psychol Med. 2013; 35:(2):121–6.
    [Google Scholar]
  16. Mackenney PJ, McQueen MM, Elton RJJ. Prediction of instability in distal radial fractures. J Bone Joint Surg Am. 2006; 88:(9):1944–51.
    [Google Scholar]
  17. Frenkel O, Herring AA, Fischer J, Carnell J, Nagdev A. Supracondylar radial nerve block for treatment of distal radius fractures in the emergency department. J Emerg Med. 2011; 41:(4):386–8.
    [Google Scholar]
  18. Isfahani MN, Shahverdi N, Golshani K. Low-Dose Intravenous Ketamine Bolus versus Conventional Technique for the Reduction of Upper and Lower Extremity Fractures in Children: A Randomised Controlled Clinical Trial. Eurasian Journal of Emergency Medicine. 2020; 19:(3):166.
    [Google Scholar]
  19. Ahmadi O, Isfahani MN, Feizi A. Comparing low-dose intravenous ketamine-midazolam with intravenous morphine with respect to pain control in patients with closed limb fracture. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences. 2014; 19:(6):502.
    [Google Scholar]
  20. Marx JA, et al. Rosen's emergency medicine: concepts and clinical practice. 8th ed. ELSEVIER SAUNDERS; 2014. p. 50–60, 584–6.
    [Google Scholar]
  21. Blaivas M, Lyon M. Ultrasound-guided interscalene block for shoulder dislocation reduction in the ED. Am J Emerg Med. 2006; 24:(3):293–6.
    [Google Scholar]
  22. Blaivas M, Adhikari S, Lander LJAEM. A prospective comparison of procedural sedation and ultrasound-guided interscalene nerve block for shoulder reduction in the emergency department. Acad Emerg Med. 2011; 18:(9):922–7.
    [Google Scholar]
  23. Ünlüer EE, Karagöz A, Ünlüer S, Koşargelir M, Kizilkaya M, Alimoğlu O, Akoğlu H, Aslan C. Ultrasound-guided supracondylar radial nerve block for Colles Fractures in the ED. Am J Emerg Med. 2016; 34:(8):1718–20.
    [Google Scholar]
  24. Büttner B, Mansur A, Kalmbach M, Hinz J, Volk T, Szalai K, Roessler M, Bergmann I. Prehospital ultrasound-guided nerve blocks improve reduction-feasibility of dislocated extremity injuries compared to systemic analgesia. A randomized controlled trial. PLOS ONE. 2018; 13:(7):e0199776.
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.5339/jemtac.2020.14
Loading
/content/journals/10.5339/jemtac.2020.14
Loading

Data & Media loading...

  • Article Type: Research Article
Keyword(s): distal radiusfracturenerve blocksedation and ultrasound-guided
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error