Mahzad Alimian1, Amir Sobhani Eraghi2, Seyyed Alireza Chavoshizadeh1, Masood Mohseni3, Elham Mousavi4, Shima Movassaghi1. 1. Department of Anesthesiology, Iran University of Medical Sciences, Tehran, Iran. 2. Department of Orthopaedics Surgery, Iran University of Medical Sciences, Tehran, Iran. 3. Department of Anesthesiology, Iran University of Medical Sciences, Tehran, Iran. Masood.mohseni@gmail.com. 4. Department of Sports Medicine, Iran University of Medical Sciences, Tehran, Iran.
Abstract
BACKGROUND:Systemic vitamin C supplementation after wrist fracture has been suggested to reduce the incidence of complex regional pain syndrome (CRPS). This study aimed to evaluate the effect of regional vitamin C in Bier block in the early phase of fracture on CRPS occurrence following surgery for distal radius fractures. METHODS:Seventy-four patients with isolated extra-articular distal radius fracture with the plan of fixation under Bier block were enrolled. Patients were assigned randomly into two groups: receiving either 500 mg vitamin C or sterile water as a Bier block adjuvant. Both groups received 500 mg of oral vitamin C for six weeks. The patients were evaluated for CRPS signs and symptoms at 2, 4, 6, and 12 weeks post-surgery. RESULTS: The overall incidence of CRPS 12 weeks after surgery in the vitamin C group was significantly less than the controls (22.9% vs 45.5%, p = 0.04). Logistic regression analysis showed that the only significant contribution in predicting the incidence of CRPS came from the intervention variable (OR 0.26, CI95% 0.08-0.85; P = 0.027). CONCLUSIONS: The findings suggest that adding vitamin C 500 mg to the local anesthetic in Bier block significantly reduces the incidence of CRPS following distal radius fractures.
RCT Entities:
BACKGROUND: Systemic vitamin C supplementation after wrist fracture has been suggested to reduce the incidence of complex regional pain syndrome (CRPS). This study aimed to evaluate the effect of regional vitamin C in Bier block in the early phase of fracture on CRPS occurrence following surgery for distal radius fractures. METHODS: Seventy-four patients with isolated extra-articular distal radius fracture with the plan of fixation under Bier block were enrolled. Patients were assigned randomly into two groups: receiving either 500 mg vitamin C or sterile water as a Bier block adjuvant. Both groups received 500 mg of oral vitamin C for six weeks. The patients were evaluated for CRPS signs and symptoms at 2, 4, 6, and 12 weeks post-surgery. RESULTS: The overall incidence of CRPS 12 weeks after surgery in the vitamin C group was significantly less than the controls (22.9% vs 45.5%, p = 0.04). Logistic regression analysis showed that the only significant contribution in predicting the incidence of CRPS came from the intervention variable (OR 0.26, CI95% 0.08-0.85; P = 0.027). CONCLUSIONS: The findings suggest that adding vitamin C 500 mg to the local anesthetic in Bier block significantly reduces the incidence of CRPS following distal radius fractures.
Entities:
Keywords:
Anesthesia; CRPS; Distal radius fracture; Pain; Vitamin C
Authors: R Norman Harden; Ann Louise Oaklander; Allen W Burton; Roberto S G M Perez; Kathryn Richardson; Melanie Swan; Jennifer Barthel; Brienne Costa; Joseph R Graciosa; Stephen Bruehl Journal: Pain Med Date: 2013-01-17 Impact factor: 3.750