Intravenous regional anesthesia in the treatment of forearm and wrist fractures and dislocations in children.
OBJECTIVE
To evaluate the efficacy and safety of intravenous regional anesthesia in the treatment of unilateral closed fractures and dislocations of forearm or wrist in children.


METHODS
A prospective study over 6 years.


METHODS
The study was undertaken in the well-equipped emergency department of a community general hospital for ambulatory patients.


METHODS
One hundred and thirty-nine children between the ages of 4 and 18 years with unilateral closed fractures and dislocations of forearm or wrist.


METHODS
All children received premedication with a combination of meperidine and promethazine (0.5 mg/kg intramuscularly) and regional upper limb anesthesia with 0.5% lidocaine solution (3 mg/kg intravenously) after inflation of an arm tourniquet.


METHODS
The relief of pain, allowing closed reduction with intravenous regional anesthesia, and the incidence of complications.


RESULTS
All patients had complete relief of pain allowing successful closed reduction in 133 patients (96%); tourniquet pain occurred in 10 patients (7%). There were no symptoms of lidocaine toxicity. There were no neurovascular or compartment syndrome complications.


CONCLUSIONS
Intravenous regional anesthesia for the treatment of fractures and dislocations of forearm and wrist in children was found to be simple, safe and effective.
Colizza
W A
WA
Department of Surgery, McGill University, Montreal, Que.
Said
E
E
D000293:Adolescent; D000765:Anesthesia, Conduction; D000771:Anesthesia, Intravenous; D002648:Child; D002675:Child, Preschool; D004551:Elbow Joint / Q000601:surgery; D005260:Female; D005543:Forearm Injuries / Q000601:surgery*; D005596:Fractures, Closed / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery*; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D011446:Prospective Studies; D011859:Radiography; D011885:Radius Fractures / Q000601:surgery; D016896:Treatment Outcome; D014458:Ulna Fractures / Q000601:surgery; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D000092464:Elbow Injuries
D008012:Lidocaine