CORR Insights(®): Does Brachial Plexus Blockade Result in Improved Pain Scores After Distal Radius Fracture Fixation? A Randomized Trial.

Abstract

R egional anesthesia provides multiple benefits in terms of perioperative pain management [3, 4]. In upper extremity surgery, brachial plexus blocks result in reduced systemic anesthetic requirements, lower perioperative opioid consumption, less nausea, and shorter postoperative stays [1, 3, 4]. Beyond the hospital, however, the benefits in regard to pain management are less clear, and surgeons may find it difficult to counsel patients about what to expect in the hours and days after the regional anesthetic wears off. Galos and colleagues have performed a randomized controlled trial to evaluate the pain experience for patients undergoing operative repair of distal radius fractures, and their findings supports the concept of ‘‘rebound pain’’ after discharge. Although patients with brachial plexus block may have little if any pain during and immediately after the procedure, 12 hours to 24 hours later the block wears off and their pain is greater than that for the general anesthetic group. The pain at this point is similar to the immediate postoperative pain for patients who underwent general anesthesia. Pain scores are documented at 2, 4, 6, 24, 48, and 72 hours, as well as at 2 weeks postoperatively, providing valuable information to providers counseling patients prior to distal radius fracture surgery.