Regional Anesthesia for the Acute Trauma Patient

Samet, Ron E.; Slade, Ian R.

doi:10.1007/s40140-018-0254-9

Cited by 2 publications

(1 citation statement)

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“…La terapia mutimodal es el eje de la analgesia dentro de la cual la técnica peridural se ha constituido en su eje central. El control del dolor alcanzado con esta técnica demuestra una amplia ventaja sobre la analgesia endovenosa tanto en efectividad, como en tiempo de estadía en intensivo y días en ventilación mecánica [120], [121], [122]. Existen otras técnicas regionales como el bloqueo del serrato, el bloqueo paravertebral o del erector espinal [123], [124], [125] que han ido demostrando su utilidad en cirugía electiva, en especial el bloqueo paravertebral que ha mostrado igual eficacia en la analgesia posoperatoria con algunas ventajas en la presentación de efectos colaterales menores.…”

Section: Manejo Del Dolorunclassified

Traumatismo torácico y anestesia

Garrido¹

2021

Rev. chil. anest.

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The thoracic trauma patient is generally of young, working age, and is often affected by multiple trauma. In its preoperative management, the functional repercussions secondary to thoracic injuries (pulmonary contusion, myocardial contusion, flail chest, etc.) should be evaluated. These become more important when anesthesia must be administered for surgical resolution of neurological, abdominal or limb injuries, and especially, when emergency thoracic surgery must be performed. Only 15% of patients with chest trauma require surgery. In emergency situations, regional techniques are limited to be a part of the postoperative analgesia or they are indicated in case of extensive nonsurgical parietal lesions. These are patients that have a full stomach in whom, in many cases, a chest drain must be installed prior to or during anesthetic induction. Induction agents that produce less hemodynamic compromise and maintenance with halogenated gases are suggested. Double-lumen endobronchial tubes are the standard method for providing lung isolation. Intraoperative mechanical ventilation should be provided considering the concepts of pulmonary protection taken from intensive medicine. Good postoperative analgesia facilitates respiratory physiotherapy, prevents deterioration of lung function, and allows early ambulation, helping altogether to reduce the incidence of pulmonary and thromboembolic complications.

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