Does the addition of peripheral nerve blocks improve analgesia during distal radius fracture reduction? A prospective, randomized, multicenter clinical trial.

Resumen del estudio

180 patients with displaced distal radius fractures requiring closed reduction were randomized to receive hematoma block alone or hematoma block combined with median nerve and superficial radial sensory nerve blocks. The primary outcome of interest was digital pain during traction and fracture reduction measured using the visual analogue scale (VAS). Secondary outcomes included wrist pain during traction and reduction, residual wrist and digital pain at discharge, radiographic reduction quality, complications, and factors associated with increased pain perception. Outcomes were assessed during traction, fracture reduction, at discharge, and through 3 months of follow-up. Overall, the results of the study revealed that the combined block significantly reduced digital pain during both traction and reduction, with differences that exceeded reported clinically important thresholds. Wrist pain and reduction quality were similar between groups. These findings suggested that adding peripheral nerve blocks to hematoma block improved procedural analgesia without compromising reduction success or increasing major complications.