Medical Journal of the Islamic Republic Of Iran

en Comparative Study of Radial and Median Nerve Blocks with Hematoma Block under Ultrasound Guide in Distal Radius Fracture Reduction: A Randomized Clinical Trial Anesthesia Anesthesia Original Research Original Research Background: Distal radius fractures are one of the most common upper extremity fractures, and their incidence continues to increase due to an aging population and an increase in osteoporosis. Various methods of analgesia for distal radius fractures have been described—including hematoma blocks and nerve blocks. Hematoma blocks are a simple and effective method of providing analgesia; nonetheless, their efficacy may be limited in some cases. On the other hand, nerve blocks provide more targeted analgesia and may be more effective in reducing pain during fracture reduction.   This study aimed to compare the analgesic effectiveness of radial and median nerve blocks with hematoma blocks under ultrasound guidance in treating distal radius fractures. Also, this study aimed to compare the analgesia of radial and median nerve blocks with hematoma blocks under ultrasound guidance to reduce distal radius fractures.    Methods: In this prospective trial, patients with distal radius fractures referring to 2 academic centers were placed into 2 randomized groups, including hematoma block, and radial median block, both of which were ultrasound-guided. The patient's pain levels were measured and recorded based on the visual analog scale before the block, 5, 10, and 15 minutes after the block, at the start of reduction, during reduction, and 5, 10, and 15 minutes after reduction. Patient satisfaction and physician satisfaction rates were assessed, and side effects were also observed for 1 week. Quantitative variables were reported as mean ± standard deviation, and number and frequency percentages were reported for qualitative variables. The Student t test and the chi-square test were used on a case-by-case basis. The significance level was set at P ˂ 0.05.    Results: In this study, 120 patients were included. The groups had no significant differences in pain reduction during the procedure. Analgesic medication was needed during the procedure for 17 patients; nerve blocks were applied for 6 patients, and hematoma blocks for 11 patients, which was statistically significant (P = 0.041). Satisfaction rates for patients and physicians performing the procedure were significantly higher in the nerve block group than in the hematoma block group (P = 0.001; P ˂ 0.001, respectively).    Conclusion: The results of this study suggest that ultrasound-guided radial and median nerve blocks can be used as alternative methods of analgesia with other techniques in the reduction of distal radius fractures Hematoma block, Nerve block, Procedural Sedation, Analgesia 886 891 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-7426-2&slc_lang=en&sid=1 Saeed Abbasi saieedabbasi@yahoo.com 200319475328460080165 200319475328460080165 No Emergency Medicine Management Research Center, Iran University of Medical Sciences, Tehran, Iran Nayyereh Garjani n.garjani@ymail.com 200319475328460080166 200319475328460080166 No Emergency Medicine Management Research Center, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran Babak Mahshidfar bmahshidfar@gmail.com 200319475328460080167 200319475328460080167 No Emergency Medicine Management Research Center, Iran University of Medical Sciences, Tehran, Iran Davood Farsi davoodfa2004@yahoo.com 200319475328460080168 200319475328460080168 No Emergency Medicine Management Research Center, Iran University of Medical Sciences, Tehran, Iran Mani Mofidi manimofidi@yahoo.com 200319475328460080169 200319475328460080169 No Emergency Medicine Management Research Center, Iran University of Medical Sciences, Tehran, Iran Peyman Hafezimoghadam hafezimoghadam@yahoo.com 200319475328460080170 200319475328460080170 No Emergency Medicine Management Research Center, Iran University of Medical Sciences, Tehran, Iran Mahdi Rezai rezaei.m@iums.ac.ir 200319475328460080171 200319475328460080171 No Emergency Medicine Management Research Center, Iran University of Medical Sciences, Tehran, Iran Alireza Javan javan.a@iums.ac.ir 200319475328460080172 200319475328460080172 Yes Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran