Department of Anesthesiology, Iran University of Medical Sciences, Tehran, Iran.
Department of Orthopaedics Surgery, Iran University of Medical Sciences, Tehran, Iran.
Eur J Orthop Surg Traumatol. 2021 May;31(4):689-693. doi: 10.1007/s00590-020-02821-0. Epub 2020 Oct 29.
Systemic vitamin C supplementation after wrist fracture has been suggested to reduce the incidence of complex regional pain syndrome (CRPS). This study aimed to evaluate the effect of regional vitamin C in Bier block in the early phase of fracture on CRPS occurrence following surgery for distal radius fractures.
Seventy-four patients with isolated extra-articular distal radius fracture with the plan of fixation under Bier block were enrolled. Patients were assigned randomly into two groups: receiving either 500 mg vitamin C or sterile water as a Bier block adjuvant. Both groups received 500 mg of oral vitamin C for six weeks. The patients were evaluated for CRPS signs and symptoms at 2, 4, 6, and 12 weeks post-surgery.
The overall incidence of CRPS 12 weeks after surgery in the vitamin C group was significantly less than the controls (22.9% vs 45.5%, p = 0.04). Logistic regression analysis showed that the only significant contribution in predicting the incidence of CRPS came from the intervention variable (OR 0.26, CI95% 0.08-0.85; P = 0.027).
The findings suggest that adding vitamin C 500 mg to the local anesthetic in Bier block significantly reduces the incidence of CRPS following distal radius fractures.
腕部骨折后全身补充维生素 C 已被建议可降低复杂性区域疼痛综合征（CRPS）的发生率。本研究旨在评估 Bier 阻滞中局部维生素 C 在桡骨远端骨折手术后发生 CRPS 的早期阶段对 CRPS 发生的影响。
74 例接受 Bier 阻滞下固定的单纯关节外桡骨远端骨折患者纳入研究。患者随机分为两组：接受 500mg 维生素 C 或 Bier 阻滞辅助用无菌水。两组均口服 500mg 维生素 C 6 周。术后 2、4、6 和 12 周评估患者 CRPS 体征和症状。
术后 12 周时，维生素 C 组的 CRPS 总发生率明显低于对照组（22.9%比 45.5%，p=0.04）。Logistic 回归分析显示，唯一能显著预测 CRPS 发生率的因素是干预变量（OR 0.26，95%CI0.08-0.85；P=0.027）。
这些发现表明，在 Bier 阻滞中加入 500mg 维生素 C 可显著降低桡骨远端骨折后 CRPS 的发生率。
