International Medical Journal, Vol. 23., Iss. 1, 2017, P. 89−92.
REGIONAL ANESTHESIA WITH PROLONGED ANALGESIA IN TREATMENT OF MULTIPLE FRACTURES OF LIMBS
Regional Clinical Hospital −− Center of Urgent Medical Aid and Disaster Medicine, Kharkiv
Kharkiv National Medical University, Ukraine
The majority of multiple fractures require immediate surgery, the amount and timing of which depend on many factors, namely equipment of the hospital, experience of the surgeon, possibility to correct homeostasis, modern anesthesia, etc. Thus, the issue of choosing the most adequate and effective anesthesia method which can allow not only to achieve the desired level of analgesia during the surgery, but also effectively correct postoperative pain, is urgent. The technique and effectiveness of regional anesthesia followed by epidural and plexus analgesia using disposable elastopomp in patients with multiple fractures of the extremities were analyzed. The quality of anesthesia was determined by a survey of the surgical team, assessment of pain by the post−operative patients using visual analog scale, quality of life in the post−operative period. Surgical interventions on the upper and lower extremities were performed under brachial plexus blockade and under subarachnoid anesthesia in accordance with the subsequent addition to the catheters of disposable elastopomps with 0.125 % solution of bupivacaine for postoperative analgesia. The elastopomps were removed on the third day after surgery. In all cases, an adequate level of analgesia of the operated limb was obtained. Intra−operative analgesia fully satisfied the surgeons during the surgery. The need for administration of opioids was absent. The quality of life after simultaneous fixation of multiple fractures of the upper and lower extremities completely satisfied the patients throughout the post−operative period. Thus, the issue of choice of most adequate and effective anesthesia promoting the desired level of analgesia during the surgery as well as effective correction of post−operative pain is urgent.
Key words: regional anesthesia, multiple fractures of the locomotive system, surgery.