Early post-operative pain lower with RA vs GA use in distal radius ORIF .
Regional or General Anesthesia in the Surgical Treatment of Distal Radial Fractures: A Randomized Clinical Trial
J Bone Joint Surg Am. 2019 Jul 3;101(13):1168-1176.90 Swedish patients presenting with a distal radius fracture undergoing open reduction and internal fixation with a volar locking plate were randomized to regional anesthesia (RA) or general anesthesia (GA). The primary outcome of interest was the total opioid consumption in morphine equivalents (OEC) during the first 3 post-operative days. Secondary outcomes included OEC before and after discharge, pain on a Visual Analog Scale (VAS), peak pain score, post-operative nausea and vomiting, grip strength, range of motion, the EQ-5D-3L score, and the Patient-Reported Wrist Evaluation (PRWE) score. Follow up was performed up to 6 months post-operation. Results from the study revealed significantly lower OEC during the first post-operative day, in favour of the RA group. IV and oral+IV OEC before discharge were significantly lower in the RA group, however OEC after discharge was significantly higher in the RA group compared to the GA group. VAS pain during the first 2 post-operative hours was significantly lower in the RA group compared to the GA group, but was significantly higher in the RA group at 24 hours post-operation compared to the GA group. The incidence of nausea 1 day post-operation was significantly lower in the RA group compared to the GA group. No significant differences between groups were observed in grip strength, range of motion, EQ-5D-3L score, or PRWE score at 6 months post-operation.
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