Comparison of the Effect of Hematoma Block and Injection of Lidocaine with and without Ketamine on Reduction of Pain in Patients with Distal Radius Fracture

Hematoma block (HB) is a technique for local anesthesia injection between fractured bone fragments. The aim of the present study was to compare the effect of HB with injection of lidocaine with and without ketamine on reduction of pain, blood pressure, and heart rate in patients with distal radius fracture.

In this randomized double-blind clinical trial study, a total of 60 patients with distal radius fracture were randomly selected and divided in two equal groups. Patients in the first group underwent HB with injection of 8 ml lidocaine 2%, and patients in group B underwent HB with injection of 8 ml lidocaine 2% plus ketamine (0.5 mg/kg). The intensity of pain, blood pressure, and heart rate were measured before, during, and after 1 and 6 hours of bone placement.

There was no significant difference in the mean pain between the two groups before bone reduction (P = 0.87). But, the mean pain significantly was lower in group B during (P = 0.004) and 1 (P < 0.001) and 6 (P < 0.001) hours after bone reduction.

According to our data, it can be concluded that combination of ketamine and lidocaine has better analgesic effect in HB technique in patients with distal radius fracture. However, further studies should be conducted to confirm our data.