Sedoanalgesia Versus Infraclavicular Block for Closed Reduction of Pediatric Forearm Fracture in Emergency Department: Prospective Randomized Study
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2021;9(18):8 Pediatr Emerg Care. 2021 Jun 1;37(6): e324-e328.What this means for my practice?
The infraclavicular nerve block appears to be a safe and effective alternative to sedoanalgesia for pediatric patients with forearm fractures requiring reduction. However, operators must have training in ultrasound guided nerve blocks to implement this into practice. This study had a small sample size and was limited to a single centre. More research is warranted in this area.
Study Summary
Sixty four pediatric patients with closed forearm fractures requiring reduction were randomized to receive sedoanalgesia (n=30) or an infraclavicular nerve block (ICB) (n=34) for pain control prior to reduction. The outcomes of interest were pain scores measured with the Wong-Baker FACES Scale (WBS), patient and practitioner satisfaction and adverse events. The ICB group had significantly lower pain scores during the reduction and significantly higher patient and practitioner satisfaction scores. The ICB group also had a significantly lower incidence of hypoxia.
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