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Similar change in pain scores seen with single vs continuous nerve blocks for extremity fractures
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NATIONAL HARBOR, Md. — Investigators found no significant differences in the change in average pain scores or number of pain pills taken between patients who received a single nerve block or continuous nerve block for surgery of distal radius or ankle fractures.
“Even though ankle fractures had higher pain scores overall and an increased number of pain medication requirements, between the two groups, there is no statistical significance found on formal testing; hence making regional anesthesia an excellent choice for postoperative pain control,” Abhishek Ganta, MD, said.
According to the study abstract, Ganta and colleagues compared 90 patients who underwent surgery for either ankle or distal radius fractures and received either a single nerve block or a continuous nerve block. An infraclavicular block was used in patients with distal radius fractures, and a popliteal-sciatic block was used for patients with ankle fractures. At 8-hours, 12-hours, 24-hours, 48-hours and 72-hours postoperatively, pain scores and the number of pain pills taken were recorded and compared between groups.
Results regarding the single nerve block group showed patients with ankle fractures had greater pain scores compared with the distal radius group during all time points, except for at 72 hours postoperatively. Ganta noted there was a peak in pain scores at 12 hours in both groups, and then scores decreased subsequently. However, the differences between the change of pain scores overtime between the ankle fracture and wrist fracture groups were not statistically significant.
Both groups, between 12 hours and 48 hours, saw an increase in the pain medication taken. This decreased after that time, with patients in the ankle fracture group showing a greater increase in the average number of pain medication taken. However, investigators found no statistically significant differences between groups regarding this outcome.
“[Regional] anesthesia works equally well in both upper and lower extremities postoperative fracture care in the form of either a continuous nerve infusion or single nerve block,” Ganta said. – by Monica Jaramillo
Reference:
Ganta A. Paper #26. Presented at: Orthopaedic Trauma Association Annual Meeting; Oct. 5-8, 2016; National Harbor, Md.
Disclosure: Ganta reports no relevant financial results.