• Jennifer Héroux, Pierre-Olivier Bessette, Sonia Bédard, Daphnée Lamarche, Anthony Gagnon, Pablo Échavé, Marie-Josée Loignon, Nicolas Patenaude, Jean-Patrice Baillargeon, and Frédérick D'Aragon.
• Department of Anesthesiology, Université de Sherbrooke, Sherbrooke, QC, Canada. jennifer.heroux@usherbrooke.ca.
• Can J Anaesth. 2023 Nov 6.

PurposeRegional anesthesia may favour postoperative rehabilitation by inhibiting peripheral sensitization and secondary hyperalgesia. The literature on this subject is limited. In the present FUNCTION study, we sought to compare the functional recovery post orthopedic wrist surgery with regional versus general anesthesia.MethodsWe conducted a single-centre prospective observational cohort study in adult patients with a distal radial fracture. Functional recovery was assessed with validated psychometrics questionnaires (Quick Disabilities of Arm, Shoulder and Hand [QuickDASH] and Patient-Rated Wrist Evaluation [PRWE]), range of motion, and grip strength. We used a linear mixed regression model to assess the impact of the anesthesia technique on functional recovery. Postoperative pain and patient satisfaction were evaluated using a visual analog scale.ResultsWe recruited 76 patients. At 12 weeks post surgery, there was no difference between the type of anesthesia and functional recovery with the QuickDASH (higher scores worse; regional anesthesia [RA], 22.7 vs general anesthesia [GA], 19.3; adjusted mean difference [aMD], -0.3; 95% confidence interval [CI], -9.6 to 9.0; P = 0.9) and PRWE (higher scores worse; RA group, 21.0 vs GA group, 20.5; aMD, -3.3; 95% CI, -12.1 to 5.6; P = 0.93) questionnaires. Range of motion, satisfaction, and postoperative pain were similar between groups. Right-hand grip strength was higher in the GA group.ConclusionRegional anesthesia was not associated with improved functional recovery compared with general anesthesia. The dominance of the operated limb was a confusion factor in all evaluation modalities. Further research taking into account the dominance of the hand is necessary to establish the effects of regional anesthesia on functional recovery.Study RegistrationClinicalTrials.gov (NCT04541745); registered 9 September 2020.© 2023. Canadian Anesthesiologists' Society.

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