Abstract
The present randomized controlled trial evaluated the usefulness of ultrasound (US)-guided
nerve block (NB) for emergency external fixation of lower leg fractures, by investigating
the time required before surgery and the clinical results stratified by the anesthesia
method (US-guided NB or general anesthesia [GA]). From June 2014 to April 2016, 40
patients who had undergone emergency surgery for external fixator application were
enrolled in the present study. We measured the lead time before the start of surgery
after the decision to perform emergency surgery in both groups. The US-guided NB group
included 17 males (85%) and 3 females (15%), with a mean age of 55.6 (range 33 to
77) years. Of these 20 patients, 12 (60%) had comorbidities such as diabetes mellitus,
hypertension, and kidney-related disease. Fracture type 42, 43, and 44 in the AO classification
were observed in 3 (15%), 12 (60%), and 5 (25%) cases, respectively. The mean interval
before emergency surgery was 4.3 (range 2 to 6.25) hours in the US-guided NB group.
In the GA group (n = 20 patients), the mean interval before emergency surgery was
9.4 (range 3 to 14) hours, and this difference was statistically significant (p < .001). In the US-guided NB group, no cases of anesthesia failure or unstable vital
signs occurred during surgery. Also, no postoperative complications related to the
anesthesia method, such as aggravation of the general condition, developed. In contrast,
1 case of postoperative atelectasis occurred in the GA group. Emergency external fixation
with US-guided NB in patients with lower extremity trauma can be implemented in less
time, regardless of the preoperative preparation, which is a requirement for GA.
Level of Clinical Evidence
Keywords
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Article info
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
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