Regional anesthesia in trauma patients

Abstract

Regional anesthetic techniques provide excellent perioperative analgesia that may improve patient outcome. Most often, regional anesthesia techniques for traumatized patients are first utilized in the operating room for procedural anesthesia or for postoperative pain control. Their use during surgery and in the postoperative period offers excellent pain control, decreases the need for systemic analgesics, faster recovery, decreases length of hospital stay and improves cardiac and pulmonary function postoperatively. Careful preanesthetic evaluation of trauma patient should be performed to diagnose and address life-threatening problems, which can cause death or serious morbidity if not treated early. This is achieved by Primary Survey by the control of airway, breathing and circulation. Once the immediately life-threatening conditions have been either excluded or treated secondary survey must be done to scan the whole patient for any other associated injures. Analgesia should be regarded as part of the resuscitation or treatment process as it brings pain relief, improved hemodynamic stability, improved organ and tissue perfusion, and overall improvements in morbidity and mortality. Monitoring for patients undergoing regional anesthesia should be the same as that provided if general anesthesia is chosen, with equipments for emergency airway management should be available.