A tide of change in the management of an old fracture?

Abstract

Colles' fractures are manipulated under a variety of anaesthetic techniques. An increasing awareness of cost and time within the National Health Service contributes to a marked change in the anaesthetic management of Colles' fractures. This paper presents the results of a survey of the anaesthetic techniques used in the larger accident and emergency (A&E) departments of the UK, and demonstrates the increasing popularity of the haematoma block compared with 5 years ago (7% in 1989 vs. 33% in 1994), at the expense of the general anaesthetic (44% in 1989 vs. 24% in 1994). The popularity of the Bier's block has remained unchanged (33% in 1989 and 1994). Local and regional anaesthetic techniques can be safely performed by A&E doctors, with appropriate monitoring, and this has beneficial resource implications for the anaesthetic department and the hospital.

Reduction of Distal Radius Fractures under Haematoma Block

“…Demographic data in our study is comparable to other studies showing mostly elderly and females affected by this fracture [5]. In our study, VAS during reduction was 0.94.…”

“…Haematoma block has been studied as a procedure for fracture reduction by various authors. Kendal et al [5] studied hematoma block in 1995. The increasing cost and time taken for general anaesthesia in comparison to hematoma block for reduction of distal radius made hematoma block more popular.…”

“…It accounts for about 16% of all fractures treated at emergency department [1][2][3][4]. Fracture distal radius is most common in elderly and more in females than males [5][6][7]. It usually occurs due to minor fall than severe trauma [8,9].…”

Adverse events associated with intravenous regional anesthesia (Bier block): a systematic review of complications

“…Intravenous regional anesthesia (IVRA; Bier block) remains a popular anesthetic technique amongst both anesthesiologists and non-anesthesiologists for various types of hand and forearm surgeries [1,2]. It is claimed to be cost-effective compared with general anesthesia and brachial plexus blocks for short ambulatory hand surgery [3].…”

Effectiveness of butorphanol as an adjuvant to lidocaine for haematoma or periosteal block: A prospective, randomised, double blind study

“…[4] The increasing popularity of haematoma block over general anaesthesia is due to its safety and effective way to anaesthetise a fracture before manipulation. [56]…”