{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T06:55:18Z","timestamp":1781592918956,"version":"3.54.5"},"reference-count":31,"publisher":"BMJ","funder":[{"name":"Kaiser Permanente Northern California Community Health Grant"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2026,5,20]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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\u2009days 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 8052\u2009patients identified, 5635 met inclusion criteria: 1895\u2009patients (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\u2009days of surgery (1.6% vs 0.5%, p&lt;0.001; aOR 3.34; 95%\u2009CI 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&lt;0.001\u2009for all).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rapm-2026-107741","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T06:20:22Z","timestamp":1781590822000},"page":"rapm-2026-107741","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Regional anesthesia for distal radius fracture repair: a multicenter retrospective cohort study of perioperative outcomes and postoperative healthcare utilization"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7992-5572","authenticated-orcid":false,"given":"Edward N","family":"Yap","sequence":"first","affiliation":[{"name":"Department of Anesthesia, The Permanente Medical Group, South San Francisco, California, USA"},{"name":"Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, California, USA"},{"name":"Division of Research, Kaiser Permanente, Pleasanton, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Wei","sequence":"additional","affiliation":[{"name":"Division of Research, Kaiser Permanente, Pleasanton, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W","family":"Zeltser","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Washington Permanente Medical Group, Bellvue, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2281-6775","authenticated-orcid":false,"given":"Jonathan","family":"Khersonsky","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, The Permanente Medical Group, Vallejo, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin-E","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, The Permanente Medical Group, Oakland, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kavenpreet S","family":"Bal","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Bernard J Tyson School of Medicine, Pasadena, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3337-1695","authenticated-orcid":false,"given":"Andrew","family":"Gray","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, California, USA"},{"name":"Department of Anesthesia, San Francisco General Hospital and Trauma Center, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"key":"2026061523201534000_rapm-2026-107741v1.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hcl.2012.02.001"},{"key":"2026061523201534000_rapm-2026-107741v1.2","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-199611000-00008"},{"key":"2026061523201534000_rapm-2026-107741v1.3","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1177\/1558944720928475","article-title":"Trends in the Incidence and Treatment of Distal Radius Fractures in the United States in Privately Insured and Medicare Advantage Enrollees","volume":"17","author":"Kakar","year":"2022","journal-title":"Hand (New York, N,Y)"},{"key":"2026061523201534000_rapm-2026-107741v1.4","article-title":"Unplanned Emergency and Urgent Care Visits After Outpatient Orthopaedic Surgery","volume":"5","author":"Williams","year":"2021","journal-title":"J Am Acad Orthop Surg Glob Res Rev"},{"key":"2026061523201534000_rapm-2026-107741v1.5","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000002458"},{"key":"2026061523201534000_rapm-2026-107741v1.6","doi-asserted-by":"crossref","first-page":"1168","DOI":"10.2106\/JBJS.18.00984","article-title":"Regional or General Anesthesia in the Surgical Treatment of Distal Radial Fractures: A Randomized Clinical Trial","volume":"101","author":"Rundgren","year":"2019","journal-title":"J Bone Joint Surg Am"},{"key":"2026061523201534000_rapm-2026-107741v1.7","doi-asserted-by":"crossref","DOI":"10.1186\/s12871-020-01044-4","article-title":"Infraclavicular nerve block reduces postoperative pain after distal radial fracture fixation: a randomized controlled trial","volume":"20","author":"Wong","year":"2020","journal-title":"BMC Anesthesiol"},{"key":"2026061523201534000_rapm-2026-107741v1.8","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph19159155","article-title":"General versus Brachial Plexus Block Anesthesia in Pain Management after Internal Fixation in Patients with Distal Radius Fracture: A Randomized Controlled Trial","volume":"19","author":"Nho","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"2026061523201534000_rapm-2026-107741v1.9","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0b013e318238becb"},{"key":"2026061523201534000_rapm-2026-107741v1.10","doi-asserted-by":"crossref","first-page":"639","DOI":"10.5435\/JAAOS-D-19-00527","article-title":"Emergency Department Utilization After Outpatient Hand Surgery","volume":"28","author":"Sivasundaram","year":"2020","journal-title":"J Am Acad Orthop Surg"},{"key":"2026061523201534000_rapm-2026-107741v1.11","doi-asserted-by":"crossref","first-page":"1247","DOI":"10.1007\/s11999-016-4735-1","article-title":"Does Brachial Plexus Blockade Result in Improved Pain Scores After Distal Radius Fracture Fixation? A Randomized Trial","volume":"474","author":"Galos","year":"2016","journal-title":"Clin Orthop Relat Res"},{"key":"2026061523201534000_rapm-2026-107741v1.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2014.01.011"},{"key":"2026061523201534000_rapm-2026-107741v1.13","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1213\/ANE.0000000000000688","article-title":"Will the Real Benefits of Single-Shot Interscalene Block Please Stand Up? A Systematic Review and Meta-Analysis","volume":"120","author":"Abdallah","year":"2015","journal-title":"Anesth Analg"},{"key":"2026061523201534000_rapm-2026-107741v1.14","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1177\/17585732211048117","article-title":"Beware the rebound effect: regional anesthesia increases opioid utilization after humerus fracture surgery","volume":"14","author":"Cunningham","year":"2022","journal-title":"Shoulder Elbow"},{"key":"2026061523201534000_rapm-2026-107741v1.15","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000325"},{"key":"2026061523201534000_rapm-2026-107741v1.16","doi-asserted-by":"crossref","first-page":"13","DOI":"10.3390\/jpm13111543","article-title":"Regional versus General Anesthesia in Postoperative Pain Management after Distal Radius Fracture Surgery: Meta-Analysis of Randomized Controlled Trials","volume":"13","author":"Roh","year":"2023","journal-title":"J Pers Med"},{"key":"2026061523201534000_rapm-2026-107741v1.17","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1177\/15589447231198265","article-title":"Regional Anesthesia for Wrist Fractures and Dislocations: Are We Really Blocking Opioid Prescribing?","volume":"20","author":"Moran","year":"2025","journal-title":"Hand (N Y)"},{"key":"2026061523201534000_rapm-2026-107741v1.18","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1097\/BOT.0000000000001021","article-title":"Continuous Infraclavicular Brachial Block Versus Single-Shot Nerve Block for Distal Radius Surgery: A Prospective Randomized Control Trial","volume":"32","author":"Ganta","year":"2018","journal-title":"J Orthop Trauma"},{"key":"2026061523201534000_rapm-2026-107741v1.19","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1111\/anae.16583","article-title":"\u201cPain as regional anaesthesia wears off\u201d or \u201crebound pain\u201d: what\u2019s in a name?","volume":"80","author":"Singla","year":"2025","journal-title":"Anaesthesia"},{"key":"2026061523201534000_rapm-2026-107741v1.20","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.541782.AD"},{"key":"2026061523201534000_rapm-2026-107741v1.21","doi-asserted-by":"publisher","DOI":"10.7812\/TPP\/22.172"},{"key":"2026061523201534000_rapm-2026-107741v1.22","doi-asserted-by":"crossref","DOI":"10.1001\/jamasurg.2017.1032","article-title":"Enhanced Recovery After Surgery Program Implementation in 2 Surgical Populations in an Integrated Health Care Delivery System","volume":"152","author":"Liu","year":"2017","journal-title":"JAMA Surg"},{"key":"2026061523201534000_rapm-2026-107741v1.23","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.rr7103a1","article-title":"CDC Clinical Practice Guideline for Prescribing Opioids for Pain - United States, 2022","volume":"71","author":"Dowell","year":"2022","journal-title":"MMWR Recomm Rep"},{"key":"2026061523201534000_rapm-2026-107741v1.24","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1016\/j.bja.2020.10.035","article-title":"Factors associated with rebound pain after peripheral nerve block for ambulatory surgery","volume":"126","author":"Barry","year":"2021","journal-title":"Br J Anaesth"},{"key":"2026061523201534000_rapm-2026-107741v1.25","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1016\/j.bja.2023.09.022","article-title":"Prophylactic dexamethasone for rebound pain after peripheral nerve block in adult surgical patients: systematic review, meta-analysis, and trial sequential analysis of randomised controlled trials","volume":"132","author":"Singh","year":"2024","journal-title":"Br J Anaesth"},{"key":"2026061523201534000_rapm-2026-107741v1.26","doi-asserted-by":"crossref","first-page":"372","DOI":"10.4097\/kja.20436","article-title":"Managing rebound pain after regional anesthesia","volume":"73","author":"Mu\u00f1oz-Leyva","year":"2020","journal-title":"Korean J Anesthesiol"},{"key":"2026061523201534000_rapm-2026-107741v1.27","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1177\/1558944720963867","article-title":"Emergency Department Utilization After Administration of Peripheral Nerve Blocks for Upper Extremity Surgery","volume":"17","author":"Loewenstein","year":"2022","journal-title":"Hand (N Y)"},{"key":"2026061523201534000_rapm-2026-107741v1.28","doi-asserted-by":"crossref","first-page":"S332","DOI":"10.1097\/SAP.0000000000003464","article-title":"Safety and Efficacy of Liposomal Bupivacaine Supraclavicular Nerve Blocks in Open Treatment of Distal Radius Fractures: A Perioperative Pain Management Protocol","volume":"90","author":"Brown","year":"2023","journal-title":"Ann Plast Surg"},{"key":"2026061523201534000_rapm-2026-107741v1.29","doi-asserted-by":"publisher","DOI":"10.7812\/TPP\/12-031"},{"key":"2026061523201534000_rapm-2026-107741v1.30","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1213\/ANE.0000000000006529","article-title":"A Systematic Review on Long-Term Postsurgical Pain Outcomes; What Is the Effect of Upper Extremity Regional Anesthesia?","volume":"137","author":"Droog","year":"2023","journal-title":"Anesth Analg"},{"key":"2026061523201534000_rapm-2026-107741v1.31","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1213\/ANE.0000000000006947","article-title":"Perioperative Regional Anesthesia on Persistent Opioid Use and Chronic Pain after Noncardiac Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","volume":"139","author":"Pepper","year":"2024","journal-title":"Anesth Analg"}],"container-title":["Regional Anesthesia &amp; Pain Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rapm-2026-107741","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T06:20:27Z","timestamp":1781590827000},"score":1,"resource":{"primary":{"URL":"https:\/\/rapm.bmj.com\/lookup\/doi\/10.1136\/rapm-2026-107741"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,15]]},"references-count":31,"alternative-id":["10.1136\/rapm-2026-107741"],"URL":"https:\/\/doi.org\/10.1136\/rapm-2026-107741","relation":{},"ISSN":["1098-7339","1532-8651"],"issn-type":[{"value":"1098-7339","type":"print"},{"value":"1532-8651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,15]]}}}