Philippine Orthopedic Center Research Board
A Randomized Trial of Closed Reduction without Analgesia, Intramuscular Nsaids, and Intravenous Sedation-Analgesia For Acute Anterior Shoulder islocation
Federico P. Aquino III, MD, Jason Paul Santiago, MD
1st Place - Podium Presentation: 25th Resident’s Research Forum,
Philippine Orthopedic Center, February 18, 2022
1st Place - Podium Presentation: 2022 Interdepartmental Research Paper Contest Philippine Orthopedic Center, December 14, 2022
Date of Completion: March 27, 2022
ABSTRACT
INTRODUCTION
The glenohumeral joint is a highly movable, unstable joint prone to dislocation.
AIM
To evaluate the clinical outcomes of closed reduction of acute anterior shoulder dislocation without analgesia, intramuscular NSAIDs (IM NSAIDs), and intravenous sedation with analgesia (IVSA), in terms of pain reduction, reduction time, ER stay duration, complications, and disability severity.
METHODS
Sixty patients with AASD aged 15 to 35 were randomly distributed into three groups for reduction without analgesia (Group 1), IM NSAIDs (Group 2), and IVSA (Group 3). Senior orthopedic residents unaware of patients’ treatment groups measured clinical outcomes. Statistical analysis utilized paired t-test, one-way analysis of variance (ANOVA), and chi-square test at 0.05 significance level.
RESULTS
The three groups were comparable in demographic profile, pain scores at baseline and one-hour post- reduction, and disability severity (p>0.05). However, IVSA hada significantly higherquantity of painreduction (p=0.0003), shorter reduction time (p=0.0001), and more prolonged ER stay (p=0.0001). There were no complications observed.
CONCLUSION
The similar pain-relieving effects of no analgesia, IM NSAIDs, and IVSA suggests their acceptable use for AASD treatment. Patients with severe pain may benefit from IVSA because it affords more pain relief and a faster reduction time.