دورية أكاديمية
Relationship Between Perioperative Regional Anesthesia and the Risk of Missing Acute Compartment Syndrome Following Tibia Fractures.
| العنوان: | Relationship Between Perioperative Regional Anesthesia and the Risk of Missing Acute Compartment Syndrome Following Tibia Fractures. |
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| المؤلفون: | Kakalecik J; From the Department of Orthopaedic Surgery & Sports Medicine, University of Florida, Gainesville, Florida., Satchell C; From the Department of Orthopaedic Surgery & Sports Medicine, University of Florida, Gainesville, Florida., Root KT; Department of Orthopaedic Surgery & Sports Medicine, College of Medicine, University of Florida, Gainesville, Florida., Vasilopoulos T; From the Department of Orthopaedic Surgery & Sports Medicine, University of Florida, Gainesville, Florida.; Department of Anesthesiology, University of Florida, Gainesville, Florida., Patrick MR; From the Department of Orthopaedic Surgery & Sports Medicine, University of Florida, Gainesville, Florida., Talerico MT; From the Department of Orthopaedic Surgery & Sports Medicine, University of Florida, Gainesville, Florida., Krupko TA; From the Department of Orthopaedic Surgery & Sports Medicine, University of Florida, Gainesville, Florida., Nin O; Department of Anesthesiology, University of Florida, Gainesville, Florida., Hagen JE; From the Department of Orthopaedic Surgery & Sports Medicine, University of Florida, Gainesville, Florida. |
| المصدر: | Anesthesia and analgesia [Anesth Analg] 2024 Jun 28. Date of Electronic Publication: 2024 Jun 28. |
| Publication Model: | Ahead of Print |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 1310650 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1526-7598 (Electronic) Linking ISSN: 00032999 NLM ISO Abbreviation: Anesth Analg Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 1998- : Baltimore, Md. : Lippincott Williams & Wilkins Original Publication: Cleveland, International Anesthesia Research Society. |
| مستخلص: | Background: The aim of this study was to determine the incidence of missed compartment syndrome in tibia fractures treated with and without regional anesthesia. Methods: A retrospective chart review was performed of patients with operative tibial shaft or plateau fractures at a single level-one trauma hospital between January 2015 and April 2022 with a minimum of 3-month follow-up. Patients under 18 years of age, an ipsilateral knee dislocation, known neurologic injury at presentation, or prophylactic fasciotomy were excluded. We defined missed acute compartment syndrome (ACS) as a postinjury motor deficit still present at the 3-month postoperative appointment. For patients that received a peripheral nerve block, we recorded whether a continuous perineural catheter or one-time single-shot injection was performed, and the number of nerves blocked. Incidence rates for ACS were calculated with exact binomial 95% confidence intervals (CIs). Morphine milligram equivalents (MMEs) consumed 24 hours after surgery, use of nerve block, nerve block timing, and type of block were compared using Mann-Whitney and Kruskal-Wallis nonparametric tests. Statistical significance was defined as P < .05. Results: The incidence of compartment syndrome diagnosed and treated during index hospitalization was 2.2% (17/791, 95% CI, 1.3%-3.4%). The incidence of missed ACS was 0.9% (7/791, 95% CI, 0.4%-1.8%). The incidence of missed ACS was not different between those who received nerve block 0.7% (4/610, 95% CI, 0.2%-1.7%), and those who did not (1.7% (3/176, 95% CI, 0.4%-4.8%) P = .19). Within patients receiving a nerve block, all patients with missed ACS (n = 4) received a perineural catheter. Similar missed ACS rates were observed between tibial shaft and plateau fractures. Patients receiving a nerve block had lower MME compared to those who did not receive a nerve block (P < .001). Conclusions: The results do not provide evidence that perioperative regional anesthesia increases the incidence of missed ACS in patients with operative tibial shaft or plateau injuries. but does decrease postoperative opioid requirements. Competing Interests: The authors declare no conflicts of interest. (Copyright © 2024 International Anesthesia Research Society.) |
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| تواريخ الأحداث: | Date Created: 20240628 Latest Revision: 20240628 |
| رمز التحديث: | 20240629 |
| DOI: | 10.1213/ANE.0000000000007084 |
| PMID: | 38941266 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1526-7598 |
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| DOI: | 10.1213/ANE.0000000000007084 |