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Master Thesis

Efficacité et innocuité de l'anesthésie intra-focale dans la prise en charge initiale des fractures déplacées de l'extrémité inférieure du radius chez l'adulte : une revue systématique de littérature

Abstract : Objectives: Haematoma block is not a very widespread practice in the management of trauma pain in France. Our aim was to investigate the efficacy and safety of haematoma block in the initial management of distal radius fractures in adults in a primary care setting. Methods: A systematic review was performed according to the Cochrane Handbook, PRISMA recommendations. After having written the protocol and defined the inclusion and exclusion criterion, MEDLINE, EMBASE, CENTRAL, PASCAL, SURGIR, Research Gate, Science Direct databases and all grey literature were reviewed. The selection of titles, abstracts and finally complete texts and the evaluation of potential risk of bias were carried out independently by both authors. Results: Amongst 1262 titles selected, 12 clinical trials and one systematic review were included and their risk of bias was evaluated. During the reduction, haematoma block was a less effective form of analgesia when compared to the Bier’s block, the brachial plexus block and general anaesthesia. Post-reduction, it was superior to IV sedation, nitrous oxide and general anaesthesia. There was no statistically significant difference in the quality of reduction except for the Bier’s block which was better. No complication was found. Haematoma block was a technique that is rapid to perform. Conclusions: Haematoma block has a favourable risk-benefit ratio, especially when considered in the context of a GP’s practice, where its lack of potentially harmful side-effects would encourage its use. Nevertheless its efficacy against pain and quality of fracture reduction has to be supported by future research work, as the evidence based on our meta-analysis remains debatable, most notably due to contradictory results and a sometimes elevated risk of bias within the studies we reviewed.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01185070
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Submitted on : Wednesday, August 19, 2015 - 9:17:10 AM
Last modification on : Tuesday, May 11, 2021 - 11:36:18 AM
Long-term archiving on: : Friday, November 20, 2015 - 10:13:34 AM

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  • HAL Id : dumas-01185070, version 1

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Clémentine Lagrange, Thomas Rocher. Efficacité et innocuité de l'anesthésie intra-focale dans la prise en charge initiale des fractures déplacées de l'extrémité inférieure du radius chez l'adulte : une revue systématique de littérature. Médecine humaine et pathologie. 2015. ⟨dumas-01185070⟩

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