Compartment syndrome and regional anaesthesia: Critical review

Klučka, Jozef; Štourač, Petr; Štouračová, Alena; Mášek, Michal; Repko, Martin

doi:10.5507/bp.2017.025

Cited by 24 publications

(20 citation statements)

References 66 publications

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“…However, the evidence for this in the literature is inconclusive and based mostly on case reports. Oftentimes, other clues were present indicating developing compartment syndrome 4 . In a review of 12 cases of pediatric compartment syndrome with epidural analgesia, Johnson did not find that epidurals delayed diagnoses but did recommend avoiding dense blocks in patients at risk for compartment syndrome 5 …”

Section: Discussionmentioning

confidence: 99%

Pediatric acute compartment syndrome due to surgical positioning: A case report

Teng

Arslan‐Carlon

2020

Pediatric Anesthesia

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Section: Discussionmentioning

confidence: 99%

Pediatric acute compartment syndrome due to surgical positioning: A case report

Teng

Arslan‐Carlon

2020

Pediatric Anesthesia

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“…Acute compartment syndrome has a reported incidence of 3.1 per 100,000 [ 1 ], with a range of 1–7.3 per 100,000 [ 2 ]. It has an incidence in men of 10 times that in women, at 7.3 per 100,000 [ 2 ], although this difference is accentuated in those who suffer ACS that is associated with fractures, for which the male to female ratio is 13:1 [ 3 ].…”

Section: Pathology and Diagnosismentioning

confidence: 99%

Regional analgesia for lower leg trauma and the risk of acute compartment syndrome

et al. 2021

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Summary Pain resulting from lower leg injuries and consequent surgery can be severe. There is a range of opinion on the use of regional analgesia and its capacity to obscure the symptoms and signs of acute compartment syndrome. We offer a multi‐professional, consensus opinion based on an objective review of case reports and case series. The available literature suggested that the use of neuraxial or peripheral regional techniques that result in dense blocks of long duration that significantly exceed the duration of surgery should be avoided. The literature review also suggested that single‐shot or continuous peripheral nerve blocks using lower concentrations of local anaesthetic drugs without adjuncts are not associated with delays in diagnosis provided post‐injury and postoperative surveillance is appropriate and effective. Post‐injury and postoperative ward observations and surveillance should be able to identify the signs and symptoms of acute compartment syndrome. These observations should be made at set frequencies by healthcare staff trained in the pathology and recognition of acute compartment syndrome. The use of objective scoring charts is recommended by the Working Party. Where possible, patients at risk of acute compartment syndrome should be given a full explanation of the choice of analgesic techniques and should provide verbal consent to their chosen technique, which should be documented. Although the patient has the right to refuse any form of treatment, such as the analgesic technique offered or the surgical procedure proposed, neither the surgeon nor the anaesthetist has the right to veto a treatment recommended by the other.

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“…Therefore, Hailer et al [23] advise refraining from epidural anesthesia in surgical procedures of the lower limb. However, other forms of regional anesthesia, such as an adductor canal block, can safely be used for pain control with less risk of delaying the diagnosis of postoperative compartment syndrome [24]. TKA patients who do not receive epidural anesthesia complaining of increasing pain despite seemingly adequate analgesic therapy should be evaluated for postoperative compartment syndrome [5].…”

Section: Diagnosismentioning

confidence: 99%

Ischemic Contracture following Compartment Syndrome Diagnosed 16 Months after Total Knee Arthroplasty: A Case Report and Review of the Literature

Boren¹,

Carter²,

Polmear³

et al. 2021

Case Rep Orthop Res

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Compartment syndrome is a rare complication of total knee arthroplasty (TKA) that if left untreated can result in irreversible neurologic deficits and muscle damage, ultimately causing loss of lower limb function, organ failure, and rarely death. Compartment syndrome following TKA may be misdiagnosed as vascular injury, peroneal nerve palsy, deep vein thrombosis, or postoperative pain and swelling, which may delay treatment. Here, we present the case of a 56-year-old female presenting with signs of common peroneal nerve neuropathy 16 months after undergoing ipsilateral TKA. Exploration of the common peroneal nerve demonstrated chronic ischemic changes with muscle necrosis within the lateral and anterior leg compartments. This case highlights compartment syndrome as a rare complication following TKA and presents the sequelae and treatment of ischemic contracture.

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Compartment syndrome and regional anaesthesia: Critical review

Cited by 24 publications

References 66 publications

Pediatric acute compartment syndrome due to surgical positioning: A case report

Pediatric acute compartment syndrome due to surgical positioning: A case report

Regional analgesia for lower leg trauma and the risk of acute compartment syndrome

Ischemic Contracture following Compartment Syndrome Diagnosed 16 Months after Total Knee Arthroplasty: A Case Report and Review of the Literature

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