Related Experiment Video
Updated: Jul 13, 2026
Structured Motor Rehabilitation After Selective Nerve Transfers
Published on: August 15, 2019
Enhanced Recovery after Distal Radius Fracture Surgery using Combined Short- and Long-Acting Nerve Blocks: a
Sébastien Campion1, Frédéric Le Saché2, Cécile Naudin3
1Anesthesiology and Perioperative Medicine, Hôpital Privé Armand Brillard, Ramsay Santé, Nogent-sur-Marne, France.
Background:
Distal radius fractures are commonly treated under regional anesthesia; however, conventional approaches face limitations, including prolonged motor block with long-acting agents and pain rebound with short-acting agents.
Objective:
To investigate whether combining a short-acting axillary block with long-acting truncal blocks at the elbow (median and radial nerves) is equivalent to a long-acting axillary block alone for postoperative pain management after distal radius fracture surgery.
Study Design:
Multicenter, prospective, randomized, open-label, parallel-group, controlled, equivalence trial.
Setting:
Seven secondary care centers in France.
Patients:
150 adults scheduled for wrist fracture osteosynthesis.
Interventions:
Patients were randomized to a long-acting axillary block alone (BAX-Alone) or a short-acting axillary block combined with long-acting median and radial nerve truncal blocks at the elbow (BAX-Asso).
Main Outcome Measures:
Pain intensity at motor block resolution (numerical rating scale, 0-10).
Results:
128 patients were analyzed (62 BAX-Alone, 66 BAX-Asso). Pain scores at motor block resolution were similar (2.18 ± 2.35vs. 2.49 ± 3.22; mean difference 0.31, 95% CI - 0.69 to 1.31); equivalence was not formally concluded. Motor block recovery was significantly shorter in BAX-Asso (4 [2-6] vs. 15 [10-19] hours, P < 0.001). Block success rates were comparable (91% vs. 98%, P = 0.08), with no difference in opioid consumption or severe pain incidence.
Conclusions:
Combining a short-acting axillary block with long-acting truncal blocks at the elbow achieves significantly faster motor recovery, while maintaining the quality of postoperative pain relief, offering a clinically relevant advantage in outpatient wrist fracture surgery.
Trial Registration:
ClinicalTrials.gov, NCT04046744.
