General versus Brachial Plexus Block Anesthesia in Pain Management after Internal Fixation in Patients with Distal Radius Fracture: A Randomized Controlled Trial

Jae-Hwi Nho, Byung-Woong Jang, Chi Young An, Jae Hwa Yoo, Sanghoon Song, Ho Bum Cho, Sang Ho Kim, Soon Im Kim, Ki Jin Jung and Byungsung Kim
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Jae-Hwi Nho: Department of Orthopaedic Surgery, Soonchunhyang University Hospital Seoul, Seoul 04401, Korea
Byung-Woong Jang: Department of Orthopaedic Surgery, Soonchunhyang University Hospital Gumi, Gumi 39371, Korea
Chi Young An: Department of Orthopaedic Surgery, Soonchunhyang University Hospital Seoul, Seoul 04401, Korea
Jae Hwa Yoo: Department of Anesthesiology and Pain Medicine, Soonchunhyang University Hospital Seoul, Seoul 04401, Korea
Sanghoon Song: Department of Anesthesiology and Pain Medicine, Soonchunhyang University Hospital Seoul, Seoul 04401, Korea
Ho Bum Cho: Department of Anesthesiology and Pain Medicine, Soonchunhyang University Hospital Seoul, Seoul 04401, Korea
Sang Ho Kim: Department of Anesthesiology and Pain Medicine, Soonchunhyang University Hospital Seoul, Seoul 04401, Korea
Soon Im Kim: Department of Anesthesiology and Pain Medicine, Soonchunhyang University Hospital Seoul, Seoul 04401, Korea
Ki Jin Jung: Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, Cheonan 31151, Korea
Byungsung Kim: Department of Orthopaedic Surgery, Soonchunhyang University Hospital Bucheon, Bucheon 14584, Korea

IJERPH, 2022, vol. 19, issue 15, 1-7

Abstract: Distal radius fractures (DRFs) are very common injuries associated with aging, and the number of fractures is increasing with the increase in the elderly population. General anesthesia or brachial plexus block (BPB) is required for fracture fixation, and acute postoperative pain control is necessary after operation. Early pain control can improve patient satisfaction and functional outcomes. In this study, we report the clinical differences in postoperative pain, according to the method of anesthesia (general anesthesia versus brachial plexus block). Volar plating was used to treat 72 patients older than 60 years who had comminuted DRF. Patients were randomized to either group A (36 patients), who underwent general anesthesia, or group B (36 patients), who underwent BPB. We compared these two groups prospectively for acute postoperative pain using a visual analog scale (VAS) at 2, 4, 6, 12, and 24 h after surgery. The VAS scores of each group were: 6.8 ± 2.5 in general anesthesia and 0.5 ± 2.3 in BPB at 2 h, postoperatively; 6.5 ± 2.4 in general anesthesia and 0.5 ± 2.4 in BPB anesthesia at 4 h, postoperatively; 5.2 ± 2.4 in general anesthesia and 1.5 ± 2.4 in BPB anesthesia at 6 h, postoperatively; 4.5 ± 2.5 in general anesthesia and 3.4 ± 2.7 in BPB anesthesia at 12 h, postoperatively; and 3.5 ± 2.5 in general anesthesia and 3.2 ± 2.7 in BPB anesthesia at 24 h, postoperatively. DRF patients with BPB anesthesia showed a lower VAS score than those subjected to general anesthesia in early postoperative period. As a result, the effect of BPB anesthesia on acute pain management after surgery was excellent, which resulted in a lower pain score compared with general anesthesia in DRF patients undergoing volar plating.

Keywords: distal radius fracture; postoperative pain management; brachial plexus block; general anesthesia (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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