Complications following regional anesthesia versus general anesthesia for the treatment of distal radius fractures

Authors

Ryan Lee, The George Washington University School of Medicine and Health Sciences, The George Washington University in Washington, 2300 M St, Washington, DC, 20037, USA. ryanlee@gwmail.gwu.edu.
Danny Lee, Department of Orthopaedic Surgery, University of Miami-Jackson Memorial Health System in Miami, Miami, FL, USA.
Pradip Ramamurti, The George Washington University School of Medicine and Health Sciences, The George Washington University in Washington, 2300 M St, Washington, DC, 20037, USA.
Safa Fassihi, Department of Orthopaedic Surgery, The George Washington University Hospital in Washington, Washington, DC, USA.
Jessica H. Heyer, Department of Orthopaedic Surgery, The George Washington University Hospital in Washington, Washington, DC, USA.
Monica Stadecker, Department of Orthopaedic Surgery, The George Washington University Hospital in Washington, Washington, DC, USA.
Michael Webber, Department of Orthopaedic Surgery, The George Washington University Hospital in Washington, Washington, DC, USA.
Alice Hughes, Department of Orthopaedic Surgery, The George Washington University Hospital in Washington, Washington, DC, USA.
Rajeev Pandarinath, Department of Orthopaedic Surgery, The George Washington University Hospital in Washington, Washington, DC, USA.

Document Type

Journal Article

Publication Date

12-1-2022

Journal

European journal of trauma and emergency surgery : official publication of the European Trauma Society

Volume

48

Issue

6

DOI

10.1007/s00068-021-01704-1

Keywords

Complications; Distal radius fracture; General anesthesia; Peripheral nerve block; Regional anesthesia

Abstract

PURPOSE: Open reduction and internal fixation (ORIF) are commonly utilized for the repair of distal radius fractures (DRF). While general anesthesia (GA) is typically administered for ORIF, recent studies have also demonstrated promising results with the usage of regional anesthesia (RA) in the surgical treatment of distal radius fractures. This study will compare complication rates between the use of RA versus GA for ORIF of DRFs. METHODS: A multi-institutional surgical registry was utilized to identify patients who had undergone ORIF for DRFs from 2005 to 2018-these patients were stratified into GA and RA cohorts. Patients were matched utilizing coarsened-exact-matching (CEM) to compare postoperative outcomes and rates of 30-day complications were compared between the two cohorts. RESULTS: Upon CEM-matching, 1191 patients receiving RA were matched to 9250 patients who had received GA, with a multivariate imbalance measure (L1) statistic of < 0.001. In the matched-cohort analysis, no significant differences were observed in rates of any complication (all p ≥ 0.083). On multivariate regression analyses, RA was not associated with increased risk for any complication (p = 0.445), minor complications (p = 0.093), major complications (p = 0.758), unplanned reoperations (p = 0.355), unplanned readmissions (p = 0.799), or mortality (p = 0.579). CONCLUSION: With similar safety profiles, RA is a safe and reasonable alternative to GA when managing DRFs surgically. RA may be the preferred anesthetic technique for ORIF of DRFs in patients at high risk with GA, such as those with reactions to GA in the past or with significant cardiopulmonary risk factors.

APA Citation

Lee, Ryan; Lee, Danny; Ramamurti, Pradip; Fassihi, Safa; Heyer, Jessica H.; Stadecker, Monica; Webber, Michael; Hughes, Alice; and Pandarinath, Rajeev, "Complications following regional anesthesia versus general anesthesia for the treatment of distal radius fractures" (2022). GW Authored Works. Paper 2209.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/2209

Department

School of Medicine and Health Sciences Student Works