REVIEW   Free access

Minerva Anestesiologica 2019 July;85(7):763-73

DOI: 10.23736/S0375-9393.19.13145-8

Copyright © 2019 EDIZIONI MINERVA MEDICA

lingua: Inglese

Acute pain management in trauma: anatomy, ultrasound-guided peripheral nerve blocks and special considerations

Theodosios SARANTEAS ¹, Iosifina KOLIANTZAKI ¹ ✉, Olga SAVVIDOU ², Marina TSOUMPA ¹, Georgia EUSTATHIOU ¹, Vasileios KONTOGEORGAKOS ², Rizos SOUVATZOGLOU ¹

¹ Second Department of Anesthesiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece; ² First Department of Orthopedics, Medical School, National and Kapodistrian University of Athens, Athens, Greece

Pain is the most common complaint amongst trauma patients throughout the perioperative period. Multimodal analgesia is currently being regarded the mainstay, with regional anesthesia techniques constituting an integral part of it. Ultrasound imaging techniques display a plethora of advantages that have pervaded regional anesthesia practice. In this review, we set out to provide several examples of injuries, to elucidate the precise anatomy of fractured bones (osteotomes), and to elaborate on certain peripheral nerve blocks employed in pain management of trauma patients. Controversies/special considerations pertaining to peripheral nerve blocks also dictate thorough analysis: as such, acute compartment syndrome, acute peripheral nerve injuries, regional anesthesia in awake or anesthetized patients, continuous peripheral nerve blocks, positioning limitations and, finally, ultrasound imaging versus neurostimulation techniques are extensively reviewed.

KEY WORDS: Wounds and injuries; Nerve block; Pain; Analgesia