Background and Aims The operative fixation of hand and forearm fractures can be carried out under general anaesthesia (GA), with or without regional anaesthesia (RA) or with RA as the sole anaesthetic technique. The use of RA may provide less post-operative pain and opioid use1. There is evidence to suggest that RA has better outcomes post-operatively in terms of range of motion and function2. We sought to determine whether there were any differences in the patient experience for patients undergoing this type of surgery at our facility.
Methods All patients undergoing forearm/hand fixations between May and November 2020 at a large teaching hospital were studied retrospectively. Cases with any RA component were compared with GA-only cases. Time in recovery, time to discharge, nausea, pain scores and post-operative opioid requirements were studied. Ethical approval was not required for this study, as per our local committee.
Results 105 patients were included with results shown below. The breakdown of cases as wrist, proximal to wrist, and distal to wrist procedures were broadly similar in the RA group and GA group (78%,5%,17% vs. 89%,4%,7%) respectively. The incidence of severe pain was 3.5% (RA) vs. 41% (GA). The incidence of nausea was 2.5%(RA) vs. 9%(GA).
Conclusions Patients who received RA only during their operative procedure experienced a better recovery profile, at least in the short-term, with better pain scores, less opioid use and a shorter recovery and hospital stay. The high incidence of severe pain in the GA only group was almost entirely abolished with the use of a RA technique.
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