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Feasibility of Hematoma Block for Closed Reduction of Fractures of Distal End of Radius

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Background: Fractures of distal radius are common and there are different modes of anesthesia to obtain pain relief prior to closed reduction. The aim of this study was to prospectively compare hematoma block alone and general anesthesia for the reduction of distal radius fractures, with respect to pain perception before and after manipulation using a visual analogue scale (VAS), patients’ acceptance and surgeons’ acceptance. Methods: In this randomized, controlled study, 60 ASA-I and II patient were divided into HB group (n=30) who received Hematoma block, compared with GA group (n=30) who received general anesthesia. Pain was assessed preoperatively and postoperatively by VAS, and intraoperatively by change in heart rate and mean arterial blood pressure from the baseline levels. Patients’ and surgeons’ acceptance with the nature of procedure were assessed using patients score and surgeons score respectively. Results: Intraoperatively, HB group patients had better hemodynamic variables when compared to GA group. The mean of postoperative VAS of HB group and GA group were 2.1 and 3.83 respectively which was statistically significant. The difference of mean score between the two groups with respect to surgeons’ score (p<0.001) and patients’ score (p<0.001) were statistically significant. Post-manipulation pain was significantly greater in patients who received general anesthesia (VAS=3.83±0.64). Conclusion: Patient acceptance and surgeons’ satisfaction is greater with a correctly performed hematoma block and is a safe and effective alternative to general anesthesia.

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Background: Fractures of distal radius are common and there are different modes of anesthesia to obtain pain relief prior to closed reduction. The aim of this study was to prospectively compare hematoma block alone and general anesthesia for the reduction of distal radius fractures, with respect to pain perception before and after manipulation using a visual analogue scale (VAS), patients’ acceptance and surgeons’ acceptance. Methods: In this randomized, controlled study, 60 ASA-I and II patient were divided into HB group (n=30) who received Hematoma block, compared with GA group (n=30) who received general anesthesia. Pain was assessed preoperatively and postoperatively by VAS, and intraoperatively by change in heart rate and mean arterial blood pressure from the baseline levels. Patients’ and surgeons’ acceptance with the nature of procedure were assessed using patients score and surgeons score respectively. Results: Intraoperatively, HB group patients had better hemodynamic variables when compared to GA group. The mean of postoperative VAS of HB group and GA group were 2.1 and 3.83 respectively which was statistically significant. The difference of mean score between the two groups with respect to surgeons’ score (p<0.001) and patients’ score (p<0.001) were statistically significant. Post-manipulation pain was significantly greater in patients who received general anesthesia (VAS=3.83±0.64). Conclusion: Patient acceptance and surgeons’ satisfaction is greater with a correctly performed hematoma block and is a safe and effective alternative to general anesthesia.

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This page is a summary of: Feasibility of Hematoma Block for Closed Reduction of Fractures of Distal End of Radius: A Comparison with General Anesthesia, Indian Journal of Anaesthesia and Analgesia, January 2018, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.5218.26.
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