Abstract:Objective To evaluate the effects of intra-articular injection of 0.25% bupivacaine on pain after closed reduction and percutaneous pinning (CRPP) in children with supracondylar fracture of the humerus. Methods A prospective cohort study was conducted on 65 children with Gartland Ⅱ and Ⅲ supracondylar humerus fractures who underwent CRPP surgery in the Affiliated Hospital of Chengde Medical College from January 2015 to January 2020. The children were randomly divided into injection group (0.25% bupivacaine injection, n=29) and control group (without injection, n=36). The general information, fracture classification, number of punctures, and time from admission to surgery were recorded and compared between the two groups of children. After CRPP operation, ibuprofen was taken orally for routine postoperative analgesia. The medication frequency and time of the first administration of ibuprofen within 24 hours after operation were recorded. On the first day after surgery, the revised Facial Pain Scale (FPS-R) was used to score the pain. And further comparison of the differences in postoperative pain among children of different ages, Gartland classification of supracondylar humerus fractures and the number of punctures were carried on. Results Compared with control group, the first medication time of ibuprofen was longer ［(2.76±0.64) h vs (1.84±0.84) h, t=4.866，P＜0.01］, and the medication frequency within 24 hours after operation was lower in injection group (P＜0.05). The FPS-R score of injection group was slightly lower than that of control group with the same fracture type and the same number of Kirschner needles, but the difference was not statistically significant (P>0.05). All patients of injection group did not experience complications related to intra-articular injection. Conclusion Intra-articular injection of 0.25% bupivacaine can reduce the demand for ibuprofen after CRPP in children with supracondylar fracture of humerus, but the reduction of FPS-R pain score has not achieved statistical benefits, which needs to be further explored by expanding the sample size.