Graham C A, Gibson A J, Goutcher C M, Scollon D
Department of Orthopaedic Surgery, Victoria Infirmary, Glasgow, UK.
Eur J Emerg Med. 1997 Dec;4(4):210-2. doi: 10.1097/00063110-199712000-00006.
The objective of this study was to determine the methods of anaesthesia used for the reduction of distal radius fractures in adults in Scotland and to compare this with the UK situation. The method used was a telephone questionnaire of accident and emergency doctors in 25 Scottish hospitals dealing with trauma. Thirty-two per cent still use general anaesthesia routinely for these procedures despite its cost, complexity and need for admission in the majority of cases. Forty-four per cent now use the Bier's block technique of regional anaesthesia, with the attendant advantages of ease of use, rapid recovery and no need for admission in the majority of patients. Twelve per cent use intravenous sedation and 12% use haematoma blocks for manipulations. It is concluded that Bier's block may be the anaesthetic method of choice for the management of distal radius fractures both in efficiency and economic terms in Scotland. However, training for Bier's blocks needs to be standardized and improved.
本研究的目的是确定苏格兰成人桡骨远端骨折复位所采用的麻醉方法,并将其与英国的情况进行比较。所采用的方法是对25家处理创伤的苏格兰医院的急诊医生进行电话问卷调查。尽管全身麻醉成本高、操作复杂且在大多数情况下需要住院,但仍有32%的医生在这些手术中常规使用全身麻醉。44%的医生现在使用区域麻醉的比尔氏阻滞技术,其具有使用方便、恢复快且大多数患者无需住院的优点。12%的医生使用静脉镇静,12%的医生使用血肿内阻滞进行手法操作。得出的结论是,无论从效率还是经济角度来看,比尔氏阻滞可能是苏格兰桡骨远端骨折治疗的首选麻醉方法。然而,对比尔氏阻滞的培训需要标准化和改进。