Trauma Patients and Acute Compartment Syndrome: Is There an Ariadne’s Thread That Can Safely Guide the Anesthesiologist/Emergency Physician Out of the Labyrinth?
Abstract
:1. Introduction
2. Trauma Patients in the ED
3. History of Acute Compartment Syndrome, Pathophysiology, Diagnosis and Management
4. Compartments of Interest at the Extremities
5. Guidelines and Recommendations
6. Discussion
7. Conclusions
8. Future Directions
Author Contributions
Funding
Conflicts of Interest
References
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Consensus on 10 Ultrasound-Guided Regional Anesthesia (UGRA) Techniques | ||
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1. | Upper Extremity | Interscalene brachial plexus block, supraclavicular brachial plexus block, radial nerve block at the level of the forearm, median nerve block at the level of the forearm, ulnar nerve block at the level of the forearm. |
2. | Trunk | Serratus anterior plane block. |
3. | Lower Extremity | Fascia iliaca plane block, femoral nerve block, popliteal sciatic nerve block, posterior tibial nerve block. |
Anesthesia Societies’ Guidelines on the Use of Peripheral Nerve Blocks (PNBs) and Acute Compartment Syndrome (ACS) | |
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Association of Anesthetists of Great Britain and Ireland | The available literature suggests that the use of neuraxial or peripheral regional techniques resulting in dense blocks of long duration, significantly exceeding the duration of surgery, should be avoided. The available literature suggests that single-shot or continuous peripheral nerve blocks using lower concentrations of local anesthetic drugs without adjuncts are not associated with delays in diagnoses provided post-injury. Postoperative surveillance is appropriate and effective. |
European Society of Regional Anaesthesia and Pain Therapy (ESRA) and the American Society of Regional Anesthesia and Pain Medicine (ASRA) Joint Committee Practice Advisory Consensus (for pediatric population only). | There is no current evidence that the use of regional anesthetics increases the risk for ACS or delays its diagnosis in children. |
French physical and rehabilitation medicine (SOFMER) and Anesthesia and Intensive care (SFAR) societies [3]. | In physical and rehabilitation medicine (PRM), in the practice of motor blocks, often distal and involving deep nerve trunks, the group of experts proposes to consider the risk of the consequences of the occurrence of a hematoma: minimal in the case of a superficial hematoma, and more significant in the case of a deep hematoma threatening a compartment syndrome. This risk must be taken into account in the benefit–risk balance. |
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Soulioti, E.; Pertsikapa, M.; Fyntanidou, B.; Limnaios, P.; Sidiropoulou, T. Trauma Patients and Acute Compartment Syndrome: Is There an Ariadne’s Thread That Can Safely Guide the Anesthesiologist/Emergency Physician Out of the Labyrinth? Medicina 2024, 60, 1279. https://doi.org/10.3390/medicina60081279
Soulioti E, Pertsikapa M, Fyntanidou B, Limnaios P, Sidiropoulou T. Trauma Patients and Acute Compartment Syndrome: Is There an Ariadne’s Thread That Can Safely Guide the Anesthesiologist/Emergency Physician Out of the Labyrinth? Medicina. 2024; 60(8):1279. https://doi.org/10.3390/medicina60081279
Chicago/Turabian StyleSoulioti, Eleftheria, Marianthi Pertsikapa, Barbara Fyntanidou, Pantelis Limnaios, and Tatiana Sidiropoulou. 2024. "Trauma Patients and Acute Compartment Syndrome: Is There an Ariadne’s Thread That Can Safely Guide the Anesthesiologist/Emergency Physician Out of the Labyrinth?" Medicina 60, no. 8: 1279. https://doi.org/10.3390/medicina60081279