Myderrizi Neritan, Mema Bilal
University Service of Surgery, Orthopedic Clinic, Regional Hospital Durres, Albania.
Med Arh. 2011;65(4):239-42. doi: 10.5455/medarh.2011.65.239-242.
An alternative to general anesthesia was tested against hematoma block by a double-blind, randomized clinical trial in reduction of Colles fracture.
96 patients more than 18 years old with displaced fractures of distal radius were selected from 2007-2009 on the basis of: 1) informed consent; 2) no contraindication to any method of analgesia; 3) no associated injury. Patients were randomized into 2 equal groups. The A group received Propofol intravenously, whereas the B group received 10 ml of 2% Lidocaine Hydrochloride into the fracture hematoma. Fractures are reduced under acceptable criteria. Pain measured by Visual Analogue Scale (VAS) was recorded before, during, and after reduction. Time to Emergency department, to manipulation and to hospital discharge is measured. In radiographic before, after reduction and a week later the radial tilt, ulnar migration and dorsal tilt are measured. Loss of these parameters were study statistically data analysis by KW statistics.
96 patients with displaced fractures of distal radius at mean age 54.3 (19-84) years old, M/F rate 37/59, left/right hand 37/58., from 2005-2008. VAS during reduction was 0 in group A and 0.97 +/- 0.7 in group B and VAS after reduction was 2.72 +/- 0.7 in group A and 2.25 +/- 0.2 in group B. Time to reduction was 2.63 +/- 0.96 hr in A and 0.90 +/- 0.47 hr in B After a week, 21 fractures lose reduction in group A and 22 in group B.
Hematoma block by local anesthetic is a safe and effective alternative to intravenous general anesthesia in reduction of Colles fracture.
通过一项双盲随机临床试验，对全身麻醉的一种替代方法与血肿阻滞在Colles骨折复位中的效果进行了测试。
从2007年至2009年选取96例18岁以上桡骨远端移位骨折患者，入选标准为：1）签署知情同意书；2）无任何镇痛方法的禁忌证；3）无合并伤。患者被随机分为两组。A组静脉注射丙泊酚，而B组将10毫升2%盐酸利多卡因注入骨折血肿。骨折在可接受的标准下进行复位。在复位前、复位过程中和复位后，通过视觉模拟评分法（VAS）记录疼痛情况。测量到达急诊科、进行手法复位和出院的时间。在复位前、复位后及一周后的X线片上测量桡骨倾斜度、尺骨移位和背侧倾斜度。通过KW统计对这些参数的丢失情况进行统计学数据分析。
96例桡骨远端移位骨折患者，平均年龄54.3（19 - 84）岁，男/女比例为37/59，左手/右手比例为37/58，时间跨度为2005年至2008年。复位过程中A组VAS评分为0，B组为0.97±0.7；复位后A组VAS评分为2.72±0.7，B组为2.25±0.2。A组复位时间为2.63±0.96小时，B组为0.90±0.47小时。一周后，A组有21例骨折复位丢失，B组有22例。
局部麻醉下的血肿阻滞在Colles骨折复位中是一种安全有效的全身静脉麻醉替代方法。
