Key result
Ultrasound-guided brachial plexus block resulted in similar patient satisfaction compared to general anesthesia for distal radius fracture surgery (effect size 0.1, p=0.572).
Why the study?
Distal radius fracture surgery is performed under general or regional anesthesia with brachial plexus block, but whether the anesthesia type affects patient outcomes is unclear.
Does regional anesthesia with brachial plexus block improve patient satisfaction compared to general anesthesia in patients undergoing surgical treatment of distal radius fractures?
Cohort (n=80)
No
Does regional anesthesia with brachial plexus block improve patient satisfaction compared to general anesthesia in patients undergoing surgical treatment of distal radius fractures?
Effect estimate: Effect size 0.1
Absolute Event Rate: 5% vs 5%
p-value: p=0.572
Patient satisfaction is similarly high for both brachial plexus block and general anesthesia in distal radius fracture surgery, but nerve block may shorten hospital stay and surgery duration.
Similar satisfaction with brachial plexus block or general anesthesia; leaves open shorter stays with nerve block pending randomized confirmation.
Background: Distal radius fracture surgery is performed under general (GA) or regional anesthesia with brachial plexus block (NB). Whether anesthesia type affects patient outcomes is unclear. This study retrospectively compared patient satisfaction between GA and NB after surgery. Methods: This was a historical cohort study of 80 (34 GA and 46 NB) patients who underwent volar plate fixation of distal radius fractures. Propensity score analysis was used to generate a set of matched cases (NB) and controls (GA), yielding 14 matched patient-pairs. The simplified patient satisfaction scale was compared for primary outcomes. Secondary outcomes were anesthesia and surgery duration, hospital stay length, adverse events, postoperative analgesic requirement, and wrist range of motion (ROM) 2 weeks and 3 months postoperatively. Results: After propensity score matching, patients in almost all cases in both groups were “Satisfied” (effect size: 0.1, p = 0.572), indicating little significant difference. Significant differences in adverse events and postoperative analgesic use observed before matching disappeared after matching. Anesthesia duration and hospital stay length were significantly shorter in the NB group (effect size: -1.27 and -0.77, p = 0.00074 and p = 0.0388, respectively), as was surgery duration (effect size: -0.84, p = 0.0122) after matching. Similar to before matching, wrist ROM significantly improved in the NB group (effect size: 1.11, p = 0.0279) in the early postoperative period, but the difference disappeared at 3 months postoperatively. Conclusions: Patient satisfaction between distal radius fracture surgery under GA and NB was similar. Nerve block could help shorten hospital stay length and surgery duration and improve postoperative functional recovery.
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Matsumura et al. (2020) conducted a cohort in Distal radius fractures (n=80). Brachial plexus block (axillary approach) vs. General anesthesia was evaluated on Patient satisfaction score at discharge (5-point scale) (Effect size 0.1, p=0.572). Ultrasound-guided brachial plexus block resulted in similar patient satisfaction compared to general anesthesia for distal radius fracture surgery (effect size 0.1, p=0.572).
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