دورية أكاديمية
Regional Anesthesia Did Not Delay Diagnosis of Compartment Syndrome: A Case Report of Anterior Compartment Syndrome in the Thigh Not Masked by an Adductor Canal Catheter.
| العنوان: | Regional Anesthesia Did Not Delay Diagnosis of Compartment Syndrome: A Case Report of Anterior Compartment Syndrome in the Thigh Not Masked by an Adductor Canal Catheter. |
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| المؤلفون: | Torrie A; Department of Internal Medicine, Penn State Health, Hershey, PA, USA., Sharma J; Department of Orthopedic Surgery, Massachusetts General Hospital, Boston, MA, USA., Mason M; Department of Orthopedic Surgery, Penn State Health, Hershey, PA, USA., Cruz Eng H; Department of Anesthesiology and Perioperative Medicine, Penn State Health, Hershey, PA, USA. |
| المصدر: | The American journal of case reports [Am J Case Rep] 2017 Apr 24; Vol. 18, pp. 444-447. Date of Electronic Publication: 2017 Apr 24. |
| نوع المنشور: | Case Reports; Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: International Scientific Information, Inc Country of Publication: United States NLM ID: 101489566 Publication Model: Electronic Cited Medium: Internet ISSN: 1941-5923 (Electronic) Linking ISSN: 19415923 NLM ISO Abbreviation: Am J Case Rep Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: <2014- > : Smithtown, NY : International Scientific Information, Inc. Original Publication: Albertson, NY : International Scientific Literature, Inc. |
| مواضيع طبية MeSH: | Anesthesia, Spinal* , Catheters*, Anterior Compartment Syndrome/*diagnosis, Arthroplasty, Replacement, Knee ; Humans ; Male ; Middle Aged |
| مستخلص: | BACKGROUND Acute compartment syndrome (ACS) of the thigh after elective primary total knee arthroplasty is rare. If not recognized and treated promptly, devastating consequences may result. Certain regional anesthesia techniques are thought to mask the symptoms of acute compartment syndrome, but there are no cases reported of adductor canal catheters masking the symptoms of thigh compartment syndrome. We report a case where symptoms and diagnosis of acute anterior thigh compartment syndrome were not masked by a functioning adductor canal catheter. CASE REPORT A 56-year-old male developed anterior thigh compartment syndrome after an elective primary total knee arthroplasty. Surgery was performed under spinal anesthesia with periarticular local infiltration analgesia. Postoperatively, an adductor canal catheter was placed, atraumatically, under ultrasound guidance in the recovery room with a plan to begin a continuous infusion of 0.2% ropivacaine 10 hours after the periarticular injection. Six hours after surgery, the patient complained of tightness and 10/10 pain in his right thigh, which was initially managed with parenteral opioids with moderate success. Continuous infusion through the adductor canal catheter was started and pain improved to 6/10 aching pain. Nonetheless, two hours after starting the continuous infusion, the patient reported tightness, swelling, and 10/10 pressure-like pain that was not relieved by the peripheral catheter infusion or PRN boluses of additional opioids. Due to the patient's symptomatology compartment pressures were measured. The anterior compartment pressure was 47 mm Hg and emergent anterior compartment fasciotomy was performed. CONCLUSIONS In this case, a functioning adductor canal catheter did not mask symptoms of, or delay diagnosis of, acute compartment syndrome in the thigh. |
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| تواريخ الأحداث: | Date Created: 20170425 Date Completed: 20171201 Latest Revision: 20240325 |
| رمز التحديث: | 20240325 |
| مُعرف محوري في PubMed: | PMC5410882 |
| DOI: | 10.12659/ajcr.902708 |
| PMID: | 28435149 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1941-5923 |
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| DOI: | 10.12659/ajcr.902708 |