Davis E T, Harris A, Keene D, Porter K, Manji M
Department of Orthopaedics and Trauma, University Hospital Birmingham NHS Trust, UK.
Injury. 2006 Feb;37(2):128-33. doi: 10.1016/j.injury.2005.08.010. Epub 2005 Oct 26.
A delay in the diagnosis of an acute compartment syndrome can be devastating to the patient. The increasing use of regional anaesthesia in the management of orthopaedic and trauma patients raises concerns about the potential for delay in the diagnosis of acute compartment syndrome. We undertook a postal survey to assess the usage of regional anaesthesia in patients with lower limb fractures. The study showed that regional anaesthesia is being used in patients at risk of compartment syndrome and without compartment pressure monitoring equipment being available. The anaesthetists questioned had seen cases of acute compartment syndrome being masked by regional anaesthesia. We recommend that there is an urgent need to establish joint guidelines between the orthopaedic and anaesthetic communities on the usage of regional anaesthesia in patients with lower limb fractures to reduce further morbidity from delays in the diagnosis of compartment syndrome.
急性骨筋膜室综合征诊断的延迟对患者可能是灾难性的。在骨科和创伤患者的治疗中，区域麻醉的使用日益增加，这引发了人们对急性骨筋膜室综合征诊断延迟可能性的担忧。我们进行了一项邮寄调查，以评估区域麻醉在下肢骨折患者中的使用情况。研究表明，区域麻醉正在用于有骨筋膜室综合征风险且没有骨筋膜室压力监测设备的患者。接受询问的麻醉医生见过区域麻醉掩盖急性骨筋膜室综合征病例的情况。我们建议，骨科和麻醉学界迫切需要就区域麻醉在下肢骨折患者中的使用制定联合指南，以减少骨筋膜室综合征诊断延迟导致的进一步发病率。
