Closed reduction of paediatric forearm fractures: nitrous oxide versus general anaesthetic
| Autor: | Justine St George, Donald P. Cawthorne, Mun Khin Chan, David G. Little |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
inorganic chemicals
Nausea Anesthetics General Nitrous Oxide Anesthesia General Fentanyl 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Forearm medicine Humans General anaesthesia Prospective Studies General anaesthetic Child Retrospective Studies business.industry Retrospective cohort study General Medicine Nitrous oxide Ulna Fractures medicine.anatomical_structure chemistry 030220 oncology & carcinogenesis Anesthesia Vomiting 030211 gastroenterology & hepatology Surgery medicine.symptom business Radius Fractures medicine.drug |
| Zdroj: | ANZ journal of surgeryReferences. 90(11) |
| ISSN: | 1445-2197 |
| Popis: | BACKGROUND Nitrous oxide with intranasal fentanyl is safe and effective in performing closed reduction of paediatric forearm fractures; however, the difference in outcome when compared to those performed under general anaesthesia (GA) is unclear. We aim to compare the outcomes of closed reduction of paediatric forearm fractures under nitrous oxide versus GA. METHODS This retrospective study based on a prospective change in protocol reviewed the medical records and radiographs of patients with forearm fractures who presented to a tertiary paediatric centre, and who subsequently underwent closed reduction under either nitrous or GA. Data on patient demographics, type and site of fracture and the method of casting were collected. The primary outcomes were loss of reduction, the need for repeat intervention and the rate of complications. RESULTS There were 301 and 362 patients in the nitrous and GA groups respectively. The overall re-intervention rate was 7.6% in the nitrous group versus 5.0% in the GA group (P = 0.155). There was no significant difference in loss of reduction which involved 9.0% in the nitrous group and 11.3% in the GA group (P = 0.320). There was no significance difference in overall complications. Nausea and vomiting comprised the majority of adverse events. CONCLUSION Closed reduction of paediatric forearm fractures performed under nitrous oxide with intranasal fentanyl is safe, effective and achieves comparable re-intervention rates and adverse events to those performed under GA in the operating theatre. |
| Databáze: | OpenAIRE |
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