Nerve block prior to radius repair may lower pain scores, shorten length of stay
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According to published results, use of a peripheral nerve block prior to distal radius repair yielded better pain control and shortened length of stay compared with use of general anesthesia.
Researchers from the University of Arizona College of Medicine performed a consecutive review of 80 patients who underwent outpatient distal radius open reduction and internal fixation from March to August 2016. Forty-three patients received a peripheral nerve block without general anesthesia prior to the procedure (nerve block group). Thirty-seven patients received general anesthesia alone prior to the procedure (no-nerve block group).
Nerve blocks were administered by anesthesiologists using either 0.5% bupivacaine with or without epinephrine or 0.5% ropivacaine with or without epinephrine. Outcome measures included length of stay (LOS) in postoperative phase 1, total LOS, complications related to the nerve block and patient-reported pain level at discharge, according to the study.
In the nerve block group, researchers found shorter phase 1 and total LOS, as well as a “statistically significant decrease” in patient-reported pain level at discharge. Mean total LOS was 72.12 minutes in the nerve block group compared with 109.18 minutes in the no–nerve block group. On a scale of 0 to 10, mean pain level at discharge was 0.93 in the nerve block group compared with 3.93 in the no-nerve block group.
One patient reported short-lasting skin irritation at the site of the nerve block injection; however, it resolved before discharge. No other complications were reported, according to the study.
“Distal radius repair is one of the most commonly performed surgeries in orthopedics. Yet, there is still debate over the optimal pain management strategy for postoperative pain control,” the authors wrote in the study. “On the basis of these results, the authors recommend the use of peripheral nerve block prior to distal radius repair in the outpatient surgery center setting to improve postoperative pain and decrease LOS,” they concluded.
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