![]() ![]() The use of regional anesthesia for orthopedic procedures mitigates some of the complications associated with general anesthesia such as nausea, vomiting, airway trauma, hypoxia, respiratory depression, and the risk of pulmonary aspiration. Regional anesthesia entails the injection of local anesthetic solution to interrupt signal transmission in peripheral nerves or spinal nerve roots that provide sensory and motor supply to operative structures. Over the past decades, regional anesthesia has become the anesthetic technique of choice for many orthopedic procedures. Anesthetic techniques for orthopedic surgical procedures include general and regional anesthesia techniques. The number of annual orthopedic procedures is forecasted to increase 4.9% annually, approaching 28.3 million surgeries by the year 2022. A total of 22.3 million orthopedic surgical procedures were performed worldwide in 2017. Orthopedic surgery is one of the most rapidly growing surgical specialties in the world. LAST treatment guidelines and rescue medications (intralipid) should be readily available during the regional anesthesia administration. Ultrasound should be used for regional anesthesia procedures to improve the efficacy and minimize complications. Regional anesthesia is safe but has an inherent risk of failure and a relatively low incidence of complications such as local anesthetic systemic toxicity (LAST), nerve injury, falls, hematoma, infection and allergic reactions. The choice of the regional block depends on patient cooperation, patient positing, operative structures, operative manipulation, tourniquet use and the impact of post-operative motor blockade on initiation of physical therapy. The choice of regional anesthesia is a unanimous decision made by the surgeon, the anesthesiologist, and the patient based on a risk-benefit assessment. Lower extremity peripheral nerve blocks include femoral nerve block, saphenous nerve block, sciatic nerve block, iPACK block, ankle block and lumbar plexus block. Upper extremity peripheral nerve blocks include interscalene, supraclavicular, infraclavicular, and axillary. Neuraxial blocks include spinal, epidural, and combined spinal epidural. ![]() Patient evaluation for regional anesthesia should include neurological, pulmonary, cardiovascular, and hematological assessments. Neuraxial anesthesia is commonly used for surgical anesthesia while peripheral nerve blocks are often used for postoperative analgesia. Regional anesthesia is an integral component of successful orthopedic surgery. ![]()
0 Comments
Leave a Reply. |
Details
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |