Ultrasound-guided supracondylar radial nerve block to manage distal radius fractures in the emergency department

Abstract

Background: 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. Methods: 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. Results: The duration of the procedure was significantly shorter in the nerve block group than in the ketamine group (p, 0.001). Physician and patient satisfaction were determined according to the unipolar Likert scale and unlike for patients (p ¼ 0.001), no significant difference was noted between the two groups for the physicians (p ¼ 0.619). Unlike nerve block, emergence reactions (p ¼ 0.038) and vomiting (p ¼ 0.009) occurred in the ketamine intervention. Conclusion: 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. © 2020 JEMTAC Journal of Emergency Medicine, Trauma and Acute Care. All rights reserved.