Peripheral nerve blocks for closed reduction of distal radius fractures—A systematic review with meta‐analysis and trial sequential analysis
Authors' conclusion
The certainty of evidence on the effect of peripheral nerve blocks for closed reduction of distal radius fractures is currently very low. Peripheral nerve blocks performed with ultrasound guidance may potentially reduce pain during closed reduction.
Study context
- Population
- Adults undergoing closed reduction of distal radius fractures
- Participants
- 312 adults · 6 trials
- Comparison
- Nerve block vs Haematoma block
- Outcome
- Co-primary: (1) quality of closed reduction (proportion needing surgery afterwards); (2) pain during closed reduction
Methodological detailstrial sequential analysis, co-primary outcomes
- Trial sequential analysis
- Co-primary outcomes
Pooled result
As reported in the abstract
Need for surgery (1 trial); pain during closed reduction (4 trials)
Nerve block
4 of 25
4 events
Haematoma block
7 of 25
7 events
Nerve block vs Haematoma blockRelative risk (96.7% CI)P value
Need for surgery, 1 trial
0.57(0.19–1.71)
P = 0.50Nerve block vs Haematoma blockMD, NRS points (0-10) (96.7% CI)P value
Pain during reduction, 4 trials; tau2 = 5.4, I2 = 97%; TSA-adj. 95% CI [−11.5; 7.3]
−2.1(−4.4 to 0.2)
P = 0.07Further pooled results
| Outcome | MD (NRS) (96.7% CI) | P value | |
|---|---|---|---|
| Pain during reduction, ultrasound-guided nerve blocks (pre-planned subgroup)Patients = 110; tau2 = 0.9, I2 = 80% | −4.1 (−5.5 to −2.6) | P < 0.01 | |
| −10−505Difference, NRS (linear scale) |
Original publication
Peripheral nerve blocks for closed reduction of distal radius fractures—A systematic review with meta‐analysis and trial sequential analysis. Acta Anaesthesiol Scand. Published 22 July 2024. doi:10.
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