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Regional Anesthesia for the Acute Trauma Patient

  • Anesthesia for Trauma (TE Grissom, Section Editor)
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Abstract

Purpose of Review

This chapter reviews recent literature to describe the utility of regional analgesic techniques in the pre-hospital, emergency department, and perioperative management of acute pain in trauma.

Recent Findings

Peripheral nerve block (PNB) techniques were once rarely taught outside the discipline of anesthesiology. Some European health systems are beginning to offer pre-hospital PNB for selected trauma patients, particularly those with femur fractures. Although the safety profile of ultrasound versus landmark-guided techniques remains uncertain, broader ultrasound availability enables more rapid learning of PNB techniques and contributes to expansion beyond perioperative care. The acute emergency setting is an attractive time to offer PNB, providing early analgesia to avoid side effects of systemic sedatives and opioids, facilitating painful procedures, and potentially shortening time to discharge/transfer.

Summary

Although acute pain after trauma is highly prevalent, studies to define outcome benefits of specific analgesic techniques are an area of ongoing inquiry. Numerous special considerations are necessary when selecting and performing PNB in trauma patients to optimize patient safety and clinical outcome.

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Authors and Affiliations

  1. Department of Anesthesiology, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, MD, 21201, USA

    Ron E. Samet

  2. Department of Anesthesiology & Pain Medicine, Harborview Medical Center, University of Washington School of Medicine, Seattle, WA, USA

    Ian R. Slade

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  1. Ron E. Samet
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  2. Ian R. Slade
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Correspondence to Ron E. Samet.

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Ron E. Samet and Ian R. Slade declare they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Anesthesia for Trauma

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Samet, R.E., Slade, I.R. Regional Anesthesia for the Acute Trauma Patient. Curr Anesthesiol Rep 8, 94–106 (2018). https://doi.org/10.1007/s40140-018-0254-9

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