{
  "abstract": "Background Distal radius fractures are among the most common fractures in adults and are frequently treated surgically. The impact of regional anesthesia on perioperative outcomes and early postoperative healthcare utilization remains unclear. This study evaluated the association between brachial plexus block use and immediate perioperative outcomes and 30-day postoperative healthcare utilization in patients undergoing surgical repair of a distal radius fracture.Methods A retrospective cohort study was performed using data from an integrated US healthcare system, including adult patients who underwent operative fixation of a distal radius fracture between 2017 and 2022. Patients were categorized based on receipt of a brachial plexus block. The primary outcome was an emergency department visit for pain within 7 days of surgery. Secondary outcomes included perioperative opioid use, postoperative anesthesia care unit pain scores, postoperative nausea and vomiting (PONV), surgical duration, and hospital length of stay.Results Among 8052 patients identified, 5635 met inclusion criteria: 1895 patients (33.6%) received no block and 3740 (66.4%) received a brachial plexus block. Block patients were older, more likely to be female, and had greater comorbidity burden and chronic pain prevalence. Block use was associated with higher odds of a pain-related emergency department visit within 7 days of surgery (1.6% vs 0.5%, p<0.001; aOR 3.34; 95% CI 1.57 to 7.11). Block patients also had lower perioperative opioid use, pain scores, PONV, and shorter surgical, postoperative anesthesia care unit, and hospital stays (p<0.001 for all).Conclusions In patients undergoing distal radius fracture repair, regional anesthesia was associated with improved acute perioperative pain, reduced opioid use, and shortened recovery time. However, it was associated with higher rates of early pain-related postoperative healthcare utilization, the drivers of which remain incompletely understood. Further investigation is needed to better understand the underlying factors contributing to these findings.",
  "authors": [
    {
      "affiliations": [
        "Department of Anesthesia, The Permanente Medical Group, South San Francisco, California, USA",
        "Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, California, USA",
        "Division of Research, Kaiser Permanente, Pleasanton, California, USA"
      ],
      "name": "Edward N Yap"
    },
    {
      "affiliations": [
        "Division of Research, Kaiser Permanente, Pleasanton, California, USA"
      ],
      "name": "Julia Wei"
    },
    {
      "affiliations": [
        "Department of Orthopedics, Washington Permanente Medical Group, Bellvue, Washington, USA"
      ],
      "name": "David W Zeltser"
    },
    {
      "affiliations": [
        "Department of Anesthesia, The Permanente Medical Group, Vallejo, California, USA"
      ],
      "name": "Jonathan Khersonsky"
    },
    {
      "affiliations": [
        "Department of Anesthesia, The Permanente Medical Group, Oakland, California, USA"
      ],
      "name": "Shin-E Lin"
    },
    {
      "affiliations": [
        "Kaiser Permanente Bernard J Tyson School of Medicine, Pasadena, California, USA"
      ],
      "name": "Kavenpreet S Bal"
    },
    {
      "affiliations": [
        "Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, California, USA",
        "Department of Anesthesia, San Francisco General Hospital and Trauma Center, San Francisco, California, USA"
      ],
      "name": "Andrew Gray"
    }
  ],
  "title": "Regional anesthesia for distal radius fracture repair: a multicenter retrospective cohort study of perioperative outcomes and postoperative healthcare utilization",
  "uid": "d57f3b8b-46fa-5166-962f-1b3b90f29de3"
}