TY  - JOUR
T1  - The Efficacy of Intra-Articular Injections for Pain Control Following the Closed Reduction and Percutaneous Pinning of Pediatric Supracondylar Humeral FracturesA Randomized Controlled Trial
AU  - Georgopoulos, Gaia
AU  - Carry, Patrick
AU  - Pan, Zhaoxing
AU  - Chang, Frank
AU  - Heare, Travis
AU  - Rhodes, Jason
AU  - Hotchkiss, Mark
AU  - Miller, Nancy H.
AU  - Erickson, Mark
Y1  - 2012/09/19
N1  - 10.2106/JBJS.K.01173
JO  - The Journal of Bone & Joint Surgery
SP  - 1633
EP  - 1642
VL  - 94
IS  - 18
N2  - Background: 
  The purpose of this single-blinded, randomized, controlled trial was to compare the analgesic efficacy of intra-articular injections of bupivacaine or ropivacaine with that of no injection for postoperative pain control after the operative treatment of supracondylar humeral fractures in a pediatric population.Methods: 
  Subjects (n = 124) were randomized to treatment with 0.25% bupivacaine (Group B) (n = 42), 0.20% ropivacaine (Group R) (n = 39), or no injection (Group C) (n = 43). The opioid doses and the times of administration as well as child-reported pain severity (Faces Pain Scale-Revised) and parent-reported pain severity (Total Quality Pain Management survey) were recorded.Results: 
  The proportion of subjects who required morphine and/or fentanyl injections was significantly (p = 0.004) lower in Group B (10%) as compared with Group R (36%) and Group C (44%). On the basis of the log-rank test, the opioid-free survival rates were significantly greater in Group B as compared to Groups C and R. Total opioid consumption (morphine equivalent mg/kg) in the first seventy-two hours postoperatively was significantly less in Group B as compared with Group C (mean difference, 0.225; [95% confidence interval (CI), 0.0152 to 0.435]; p = 0.036). Parent-reported pain scores were also significantly lower in Group B as compared with both Group C (mean difference, 1.81 [95% CI, 0.38 to 3.25]; p = 0.014) and Group R (mean difference, 1.66; 95% CI, 0.20 to 3.12; p = 0.027). There were no significant differences across the three groups in terms of self-reported pain. Differences between Groups R and C were not significant for any of the outcome variables.Conclusions: 
  The intra-articular injection of 0.25% bupivacaine significantly improves postoperative pain control following the closed reduction and percutaneous pinning of supracondylar humeral fractures in pediatric patients.Level of Evidence: 
  Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
SN  - 0021-9355
M3  - doi: 10.2106/JBJS.K.01173
UR  - http://dx.doi.org/10.2106/JBJS.K.01173
ER  -