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急性四肢间隔综合征和(区域性):麻醉:床下之怪物。

Acute Extremity Compartment Syndrome and (Regional): Anesthesia: The Monster Under the Bed.

机构信息

Institute of Anaesthesiology, Triemli City Hospital Zurich, Birmensdorferstrasse 497, 8063 Zürich, Switzerland; Balgrist Campus, Lengghalde 5, 8008 Zürich, Switzerland.

Department of Anesthesia, Norfolk and Norwich University Hospital NHS Trust, Regional Anesthesia UK (RA-UK), Colney Lane, Norwich NR4 7UY, UK.

出版信息

Anesthesiol Clin. 2022 Sep;40(3):491-509. doi: 10.1016/j.anclin.2022.06.001. Epub 2022 Aug 2.

Abstract

Acute compartment syndrome (ACS) is a potential orthopedic emergency that leads, without prompt diagnosis and immediate treatment with surgical fasciotomy, to permanent disability. The role of regional anesthesia (RA) for analgesia in patients at risk for ACS remains unjustifiably controversial. This critical review aims to improve the perception of the published literature to answer the question, whether RA techniques actually delay or may even help to hasten the diagnosis of ACS. According to literature, peripheral RA alone does not delay ACS diagnosis and surgical treatment. Only in 4 clinical cases, epidural analgesia was associated with delayed ACS diagnosis.

摘要

急性间隔综合征(ACS)是一种潜在的骨科急症,如果不能及时诊断和立即进行筋膜切开术治疗,将导致永久性残疾。在有 ACS 风险的患者中,区域麻醉(RA)用于镇痛的作用仍然存在争议。本批判性综述旨在提高对已发表文献的认识,以回答 RA 技术是否实际上会延迟甚至有助于加速 ACS 诊断的问题。根据文献,单独使用外周 RA 不会延迟 ACS 的诊断和手术治疗。只有在 4 例临床病例中,硬膜外镇痛与 ACS 诊断延迟有关。

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