Prehospital ultrasound-guided nerve blocks improve reduction-feasibility of dislocated extremity injuries compared to systemic analgesia. A randomized controlled trial

30 patients with an isolated extremity injury and being treated in a prehospital setting were randomized to analgesia provided through either an ultrasound-guided, single-shot nerve block or an intravenous analgesia with ketamine. Groups were assessed for the rate of patients with pain at various points during treatment and care, as well as the severity of pain among those who had experienced pain. Results demonstrated a significantly lower rate of pain among patients, as well as significantly lower pain severity, during treatment immediately following administration of analgesia. Specifically, during the reduction in applicable cases, pain severity was lower among the PNB group compared to the IV group, though the rate of patients with pain did not significantly differ between groups. For the remainder of the day of injury and on the first-day post-injury, the group administered the PNB demonstrated both a significantly lower rate of patients with pain and significantly lower pain severity among those with pain.