{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T19:52:33Z","timestamp":1778356353096,"version":"3.51.4"},"reference-count":13,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T00:00:00Z","timestamp":1658966400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2022,10]]},"abstract":"Abstract<\/jats:title>Objective<\/jats:title>We compare periosteal block and intravenous regional anesthesia (IVRA<\/jats:styled-content>) as anesthetic techniques for reduction of distal radius fractures when performed by emergency department (ED)<\/jats:styled-content> clinicians following brief training.<\/jats:p><\/jats:sec>Methods<\/jats:title>This was a single\u2010center, nonblinded randomized controlled trial of a convenience sample of patients presenting with distal radius fractures requiring closed reduction. Primary outcome measure was patient reported fracture reduction pain score, rated on a 100\u2010mm visual analog scale. Secondary outcomes included adjunct pain medication use, ED<\/jats:styled-content> length of stay, remanipulation rates, participant satisfaction, clinician assessed efficacy, and clinician\u2010assessed ease of the procedure.<\/jats:p><\/jats:sec>Results<\/jats:title>Eighty\u2010one patients were randomized to receive IVRA<\/jats:styled-content> (n<\/jats:italic>\u00a0=\u200941) or periosteal block (N<\/jats:italic>\u00a0=\u200940). Reduction pain scores were not normally distributed. Median (25th\u201375th percentile) pain scores in participants assigned to IVRA<\/jats:styled-content> and periosteal block were 5 (1\u201327.5) and 26 (8.5\u201363)\u00a0mm, respectively, (p<\/jats:italic>\u00a0=\u20090.007). Use of adjunct medications during reduction was higher for the periosteal block group compared with IVRA<\/jats:styled-content> (57.5% vs. 22.5%, p<\/jats:italic>\u00a0=\u20090.003). Remanipulation rates were 17.5% for periosteal block versus 7.5% for IVRA<\/jats:styled-content> (p<\/jats:italic>\u00a0=\u20090.31). There was no difference in length of stay, patient satisfaction, or clinician's assessed ease of the anesthetic technique. There was a difference in clinician's assessment of efficacy between groups, with IVRA<\/jats:styled-content> described as \u201cextremely effective\u201d by 65% and periosteal block described as \u201cextremely effective\u201d by 25% (p<\/jats:italic>\u00a0=\u20090.003).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>When performed by a diverse group of ED clinicians periosteal block provided inferior analgesia to IVRA but may provide an alternative when IVRA cannot be performed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.14555","type":"journal-article","created":{"date-parts":[[2022,6,29]],"date-time":"2022-06-29T09:24:50Z","timestamp":1656494690000},"page":"1213-1220","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Periosteal block versus intravenous regional anesthesia for reduction of distal radius fractures: A randomized controlled trial"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1614-5058","authenticated-orcid":false,"given":"Sierra","family":"Beck","sequence":"first","affiliation":[{"name":"Department of Medicine University of Otago Dunedin New Zealand"},{"name":"Dunedin Hospital Southern District Health Board Dunedin New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alana","family":"Brunner\u2010Parker","sequence":"additional","affiliation":[{"name":"Dunedin Hospital Southern District Health Board Dunedin New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosemary","family":"Stamm","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Otago Dunedin New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Micheal","family":"Douglas","sequence":"additional","affiliation":[{"name":"Dunedin Hospital Southern District Health Board Dunedin New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aileen","family":"Conboy","sequence":"additional","affiliation":[{"name":"Dunedin Hospital Southern District Health Board Dunedin New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,7,28]]},"reference":[{"key":"e_1_2_11_2_1","first-page":"Cd003320","article-title":"Anaesthesia for treating distal radial fracture in adults","volume":"3","author":"Handoll HH","year":"2002","journal-title":"Cochrane Database Syst 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perception during the phases of manual reduction of distal end radius fracture with a periosteal block","volume":"13","author":"Wan Ali WAA","year":"2021","journal-title":"Cureus"}],"container-title":["Academic Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acem.14555","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/acem.14555","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acem.14555","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T03:03:34Z","timestamp":1692587014000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/acem.14555"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,28]]},"references-count":13,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2022,10]]}},"alternative-id":["10.1111\/acem.14555"],"URL":"https:\/\/doi.org\/10.1111\/acem.14555","archive":["Portico"],"relation":{},"ISSN":["1069-6563","1553-2712"],"issn-type":[{"value":"1069-6563","type":"print"},{"value":"1553-2712","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,28]]},"assertion":[{"value":"2022-05-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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