Uses of nerve block in shoulder dislocation in emergency department - a systematic review

Abstract

Background: Nerve block is a potentially helpful localized analgesic technique for reducing shoulder dislocation and humorous fractures in the emergency room. Examining the usefulness of NB pain reduction, adverse events, patient satisfaction, and LOS in the ED is the objective of this systematic review. Method: We conducted an electronic search of EMBASE, MEDLINE, and the Cochrane Library in addition to a manual search of the references, included articles were RCTs published between 2002 to 2022 comparing PSA with NBs for orthopedic reductions in the ED. Interest grabbing outcomes were pain ratings, adverse events, LOS in the ED, and patient satisfaction. Results: Six studies were included in the final analysis. Consequently, 256 patients from 6 RCTs were included; 127 of them underwent PSA and 129 NB. When comparing the PSA group to the NB group, the PSA group reported adverse events more frequently. The NB group only experienced a transient systemic toxicity that resolved on its own without the need for further treatment or intervention. Hypoventilation with decreased saturation of oxygen was the most frequent adverse event seen in the patient underwent PSA. Regarding LOS all studies showed shorter LOS in patients underwent NB. Conclusion: We found no appreciable difference in pain ratings for ED fracture or dislocation reductions between PSAs and NBs in this thorough investigation. NBs appear to be associated with a shorter duration of stay and fewer unfavorable events in the ED.