Regional anesthesia and acute compartment syndrome: principles for practice

2021 ◽  
pp. rapm-2021-102735
Author(s):  
Tim Dwyer ◽  
David Burns ◽  
Aaron Nauth ◽  
Kaitlin Kawam ◽  
Richard Brull
Keyword(s):  
Compartment Syndrome ◽  
Regional Anesthesia ◽  
Clinical Symptoms ◽  
Motor Nerve ◽  
Acute Compartment Syndrome ◽  
Clinical Settings ◽  
Tissue Ischemia ◽  
Orthopedic Surgical Procedures ◽  
Cardinal Symptom ◽  
Symptoms And Signs

Acute compartment syndrome (ACS) is a potentially reversible orthopedic surgical emergency leading to tissue ischemia and ultimately cell death. Diagnosis of ACS can be challenging, as neither clinical symptoms nor signs are sufficiently sensitive. The cardinal symptom associated with ACS is pain reported in excess of what would otherwise be expected for the underlying injury, and not reasonably managed by opioid-based analgesia. Regional anesthesia (RA) techniques are traditionally discouraged in clinical settings where the development of ACS is a concern as sensory and motor nerve blockade may mask symptoms and signs of ACS. This Education article addresses the most common trauma and elective orthopedic surgical procedures in adults with a view towards assessing their respective risk of ACS and offering suggestions regarding the suitability of RA for each type of surgery.

scholarly journals Acute Compartment Syndrome of the Extremities and Paraspinal Muscles

2021 ◽  
Author(s):  
Balaji Zacharia ◽  
Raj Vignesh Selvaraj
Keyword(s):  
Compartment Syndrome ◽  
Clinical Features ◽  
Older Patients ◽  
Young Patients ◽  
The Body ◽  
Acute Compartment Syndrome ◽  
Tissue Ischemia ◽  
Important Symptom ◽  
The Common ◽  
Conscious Patient

Acute compartment syndrome (ACS) occurs when the pressure within the closed osteo-fascial compartment raises above perfusion pressure leading to irreversible tissue ischemia and necrosis. Any closed compartment in the body can be affected by ACS. The leg is the commonest site. Trauma is the common cause of compartment syndrome in young patients. In older patients, medical causes can cause it. The diagnosis in a conscious patient can be made based on clinical features. Pain out of proportion to the injury is the most important symptom. Exacerbation of pain on stretching the affected muscles and paresthesia are the common signs. Compartment pressure measurement is important for the diagnosis in unconscious and uncooperative patients. The treatment of established ACS is emergency fasciotomy. Untreated compartment syndrome can lead to neurovascular injuries and muscle contractures. In this chapter, we will see the etiologies, clinical features, investigations, and management of acute compartment syndrome of the extremities and the paraspinal region.

scholarly journals Acute Compartment Syndrome

2020 ◽  
Vol 63 (3) ◽  
pp. 124-127
Author(s):  
Jana Cepková ◽  
Leoš Ungermann ◽  
Edvard Ehler
Keyword(s):  
Case Report ◽  
Compartment Syndrome ◽  
Clinical Findings ◽  
Acute Compartment Syndrome ◽  
Tissue Ischemia ◽  
Chemical Damage ◽  
Frequent Finding ◽  
Muscle Necrosis

Acute compartment syndrome occurs most frequently in connection with injuries, terminal or chemical damage of tissues, ischemia, the activity of toxins or in patients with tissue ischemia or muscle necrosis. Clinical findings have found pronounced pain, followed by paresthesias, pallor, and paresis. Decreased pulsation of arteries has also been a frequent finding. In severe forms decompressive fasciotomy has been indicated within the first 12–24 hours after diagnosis. In the following paper, the authors present the case report of a 68-year woman who swallowed 1500 mg of trazodone as an attempt at suicide. After 12 hours her husband found her lying on the carpet with compression of the left arm under the trunk. The patient was treated conservatively and followed clinically, examined by ultrasonography, EMG and finally MRI.

Acute Compartment Syndrome of the Thigh in Combat Casualties

2013 ◽  
Vol 22 (01) ◽  
pp. 42-49 ◽  
Author(s):  
Brendan D. Masini ◽  
Adam W. Racusin ◽  
Joseph C. Wenke ◽  
Tad L. Gerlinger ◽  
Joseph R. Hsu
Keyword(s):  
Compartment Syndrome ◽  
Acute Compartment Syndrome ◽  
Combat Casualties

Scoring System for the Diagnosis of COVID-19

2020 ◽  
Vol 13 (1) ◽  
pp. 413-414 ◽  
Author(s):  
Mohamed Farouk Allam
Keyword(s):  
Scoring System ◽  
Clinical Symptoms ◽  
False Negative ◽  
Nasopharyngeal Swab ◽  
Rt Pcr ◽  
Pcr Assay ◽  
Negative Results ◽  
False Negative Results ◽  
Symptoms And Signs

Due to the international spread of COVID-19, the difficulty of collecting nasopharyngeal swab specimen from all suspected patients, the costs of RT-PCR and CT, and the false negative results of RT-PCR assay in 41% of COVID-19 patients, a scoring system is needed to classify the suspected patients in order to determine the need for follow-up, home isolation, quarantine or the conduction of further investigations. A scoring system is proposed as a diagnostic tool for suspected patients. It includes Epidemiological Evidence of Exposure, Clinical Symptoms and Signs, and Investigations (if available). This scoring system is simple, could be calculated in a few minutes, and incorporates the main possible data/findings of any patient.

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