Evolving Compartment Syndrome Not Masked by a Continuous Peripheral Nerve Block: Evidence-Based Case Management. Issue 4 (1st July 2012)

• Record Type: Journal Article
• Authors: Walker, Benjamin J.; Noonan, Kenneth J.; Bosenberg, Adrian T.
• Is Part Of: Regional anesthesia and pain medicine. Volume 37:Issue 4(2012)
• Page Start: 393
• Page End: 397
• Publication Date: 2012-07-01
• Subjects: Conduction anesthesia -- Periodicals; Pain medicine -- Periodicals; 617.964
• DOI: 10.1097/AAP.0b013e31824df1ac
• Languages: English
• ISSNs: 1098-7339

Abstract

Abstract : Abstract: Compartment syndrome is a potentially devastating complication of many orthopedic surgeries. Whether regional anesthesia can delay the diagnosis of compartment syndrome remains a subject of debate. Previous case reports have described compartment syndrome primarily in the setting of an epidural infusion, but also following single-injection peripheral nerve blocks. A case of evolving compartment syndrome in an ambulatory setting that was not masked by a continuous peripheral nerve block is presented, followed by a discussion of the literature pertaining specifically to peripheral nerve blockade and the diagnosis of compartment syndrome. Diagnosis depends on close postoperative monitoring of analgesic use and pain trends, and patients with ambulatory catheters require thorough education about compartment syndrome so they can be evaluated in a timely manner. The current literature on compartment syndrome diagnosis and regional anesthesia is limited to case reports and expert opinion, making evidence-based recommendations difficult.