Regional anesthesia for the trauma patient: improving patient outcomes.
Abstract
Trauma is a significant health problem and a leading cause of death in all age groups.
Pain related to trauma is frequently severe, but is often undertreated in the trauma
population. Opioids are widely used to treat pain in injured patients but have a broad
range of undesirable effects in a multitrauma patient such as neurologic and respiratory
impairment and delirium. In contrast, regional analgesia confers excellent site-specific
pain relief that is free from major side effects, reduces opioid requirement in trauma
patients, and is safe and easy to perform. Specific populations that have shown benefits
(including morbidity and mortality advantages) with regional analgesic techniques
include those with fractured ribs, femur and hip fractures, and patients undergoing
digital replantation. Acute compartment syndrome is a potentially devastating sequela
of soft-tissue injury that complicates high-energy injuries such as proximal tibia
fractures. The use of regional anesthesia in patients at risk for compartment syndrome
is controversial; although the data is sparse, there is no evidence that peripheral
nerve blocks delay the diagnosis, and these techniques may in fact facilitate the
recognition of pathologic breakthrough pain. The benefits of regional analgesia are
likely most influential when it is initiated as early as possible, and the performance
of nerve blocks both in the emergency room and in the field has been shown to provide
quality pain relief with an excellent safety profile.
Type
Journal articlePermalink
https://hdl.handle.net/10161/15734Published Version (Please cite this version)
10.2147/LRA.S55322Publication Info
Gadsden, Jeff; & Warlick, Alicia (2015). Regional anesthesia for the trauma patient: improving patient outcomes. Local Reg Anesth, 8. pp. 45-55. 10.2147/LRA.S55322. Retrieved from https://hdl.handle.net/10161/15734.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Jeffrey Charles Gadsden
Professor of Anesthesiology

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