Comparing the success of hematoma block with and without ultrasound guidance in reducing pain in the reduction of distal radius fractures in patients referred to the emergency room

Document Type : Research Paper

Authors

1 Associate Professor, Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Assistant, Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Asistant Professor, Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

4 Management of health and treatment services - Peymaniye Hospital Clinical Research Development Unit

Abstract

Introduction: Using radius hematoma block method can provide good anesthesia in distal radius fractures, but sometimes it is difficult to do it using anatomical landmarks. Performing the block procedure under ultrasound guidance can improve the success rate of the block and pain relief during delivery.
Methods: In this double-blind clinical trial study, 100 patients over 15 years of age with acute distal radius fracture were randomly assigned to two groups of hematoma block without ultrasound guidance and hematoma block with ultrasound guidance (47 people). Examining the amount of pain during block and insertion based on a Likert scale of 0 to 10 (0=no pain and 10=most pain) during insertion and half an hour after insertion was done and compared in two groups.
Results: In this study, 69% of participating patients were women, the average age of patients in the group with ultrasound guidance was 47.25 years and in the group without ultrasound guidance was 55.16 years. The average number of VAS during descent in the group with ultrasound guidance and without ultrasound guidance was 5.42 and 5.81, respectively, and half an hour later, it was 1.91 and 2.33, respectively.
Conclusion: It seems that performing hematoma block under ultrasound guidance especially in cases where there are no suitable local landmarks or for reasons such as swelling of soft tissue, bone anatomy, crushing of fracture fragments, or the presence of interfering factors in diagnosing the exact location of the fracture. Hematoma block becomes complicated and difficult, it can be very helpful.

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References

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Medical Journal of Mashhad university of Medical Sciences
Volume 67, Issue 4
May and June 2024
Pages 1222-1230

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