372 posters, 1 audios, 13 topics, 29 sessions, 1,035 authors, 449 institutions

51st Annual Regional Anesthesiology and Acute Pain Medicine Meeting

April 16 - 18, 2026 | Phoenix, Arizona

2313910

Regional Anesthesia Is Associated With Increased Postoperative Healthcare Utilization After Distal Radius Fracture Repair

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Poster Presenter

Julia Collins

Authors

Julia R. Collins, MD, Julia Wei, MPH, David W. Zeltser, MD, Jonathan Khersonsky, MD, Shin-e Lin, MD, Andrew Gray, MD, PhD, Edward N. Yap, MD

Affiliations

University of California, San Francisco, Division of Research, Kaiser Permanente Northern California, Department of Orthopedics, Washington Permanente Medical Group, Department of Anesthesia, The Permanente Medical Group, Kaiser Permanente Napa Solano, Department of Anesthesia, The Permanente Medical Group, Kaiser Permanente East Bay, Department of Anesthesia and Perioperative Care, University of California San Francisco, Department of Anesthesia, The Permanente Medical Group, Kaiser Permanente South San Francisco; Department of Anesthesia and Perioperative Care, University of California San Francisco

Part of Topic

Scientific Abstracts > Regional Anesthesia

Regional Anesthesia Is Associated With Increased Postoperative Healthcare Utilization After Distal Radius Fracture Repair

Julia Collins, MD1,2; Julia Wei, MPH3; David W. Zeltser, MD4; Jonathan Khersonsky, MD5; Shin-e Lin, MD6; Andrew Gray, MD, PhD2; Edward N. Yap, MD1,2

1. Department of Anesthesia, The Permanente Medical Group, Kaiser Permanente South San Francisco, South San Francisco, CA, USA; 2.Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, CA, USA; 3.Division of Research, Kaiser Permanente Northern California, Pleasanton, CA, USA; 4.Department of Orthopedics, Washington Permanente Medical Group, Bellevue, WA, USA; 5.Department of Anesthesia, The Permanente Medical Group, Kaiser Permanente Napa Solano, Vallejo, CA, USA; 6. Department of Anesthesia, The Permanente Medical Group, Kaiser Permanente East Bay, Oakland, CA, USA

Background

•Distal radius fractures (DRF) are among the most common adult fractures and are often treated surgically 1

•Anesthetic management typically involves general anesthesia with an analgesic brachial plexus block

•This study examines whether the addition of a brachial plexus block influences perioperative outcomes and postoperative health care utilization in patients undergoing operative repair of DRFs

Methods

•A retrospective cohort study was performed within an integrated United States healthcare system, comparing adult patients who received a brachial plexus block to those who did not for all surgically treated DRFs from 2017-2022

•The primary outcome was return to the emergency department (ED) for pain within 7 days post-operatively

•Secondary outcomes included perioperative opioid consumption, PACU pain scores, postoperative nausea and vomiting (PONV), surgical duration, hospital and PACU length of stay

•Sub-analysis of the block group examined differences in outcomes between single-shot blocks, catheters, and use of liposomal bupivacaine

Results

•8,052 patients underwent surgical repair of a DRF during the study period; 5,635 patients met eligibility criteria

•3,740 patients (66.4%) received a brachial plexus block (continuous catheter or single shot block), and 1895 patients (33.6%) received no block

•Block patients had lower intraoperative and PACU opioid consumption (MME), lower PACU pain scores (VAS), lower PONV, surgical duration, and length of stay (Table 1)

•Patients who received a block were more likely to present to the ED within 7 days due to pain compared to those who did not receive a block (Table 1; Table 2)

•Most pain related ED visits in the block cohort occurred on post-operative day 1 (Figure 1)

•Trend toward decreased 30-day opioid refill for patients who had a catheter-based block or liposomal bupivacaine compared to single shot block

Discussion

•Utilization of a regional anesthetic technique was associated with improved early perioperative outcomes in a large cohort of patients who underwent surgical DRF repair, consistent with prior studies 2,3

•Patients who received a catheter-based or single-shot block showed higher unplanned healthcare utilization and greater need for opioid refills

•These findings highlight the need to investigate mitigation strategies for rebound pain, including injectate adjuncts, catheters, extended-duration local anesthetics, and patient education

Funding: This study was funded by the Kaiser Permanente Community Health Grant

References

1.Nellans KW, Kowalski E, Chung KC. The epidemiology of distal radius fractures. Hand Clin. 2012;28(2):113-125. doi:10.1016/j.hcl.2012.02.001

2.Wong SS, Chan WS, Fang C, et al. Infraclavicular nerve block reduces postoperative pain after distal radial fracture fixation: a randomized controlled trial. BMC Anesthesiol. 2020;20(1):130. Published 2020 May 28. doi:10.1186/s12871-020-01044-4

3.Nho JH, Jang BW, An CY, et al. General versus Brachial Plexus Block Anesthesia in Pain Management after Internal Fixation in Patients with Distal Radius Fracture: A Randomized Controlled Trial. Int J Environ Res Public Health. 2022;19(15):9155. Published 2022 Jul 27. doi:10.3390/ijerph19159155