Regional Anesthesia for Lower Limb Burn Wound Debridements

نویسندگان

  • Indu M Sen
  • Ramesh K Sen
چکیده

This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. We read with interest the article by Rimaz et al.(1). However , there are few queries. We would like to know about the duration of burn injuries. Pain threshold can vary among patients suffering from acute burns posted for first debridement before eschar formation in comparison to patient posted for second or third debridement (2). Similarly, a patient with previous exposure to anesthesia is expected to be more familiar to the setting and the use of Patient Controlled Analgesia (PCA) devices. It appears unethical to not provide any pain relief for patients with up to 35% of total body surface area burns (3). As a result, all the patients excluding patients with daily intake of analgesics, need to be justified. Alternatively, withholding the night dose of analgesic would have sufficed. All the patients enrolled in the study were ASA I or II with lower extremity burn injuries. What was the position of the patient during surgery? In hemodynamically stable, compliant patients, the procedure could have been safely performed under regional anesthesia i.e. a combination of low-dose spinal with lumbar epidural anesthesia or a regional block with adjuvants can be tried for long-term pain relief (4). This could further be supplemented with intravenous sedation and analgesia, a cost-effective alternative of general anesthesia. Moreover, continuous infusion of local anesthetics along with adju-vants via epidural or peripheral route are suggested to be used for postoperative pain relief. Another advantage of this technique is the reduced incidence of postoperative nausea and vomiting. While using regional anaesthetic regimen, preoperative administration of oral gabapen-tin tablet would lead to reduced postoperative morphine consumption for analgesic purpose. Abstract reads that pain was assessed on a visual analogue scale at rest and during movement at different time intervals before the operation. and 24 h after the operation.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Management of musculoskeletal injuries after the 2009 western Sumatra earthquake.

PURPOSE To report injury patterns and management of musculoskeletal injuries after an earthquake. METHODS 94 male and 161 female patients aged 17 to 90 (mean, 53) years underwent surgery for musculoskeletal injuries. Their injury patterns, anaesthesia administered, surgeries undertaken, and development of postoperative complications were reviewed. RESULTS Of the 255 patients, 155 sustained ...

متن کامل

[Peripheral regional analgesia with lidocaine in burned patient: case report.].

BACKGROUND AND OBJECTIVES Regional anesthesia is difficult in burned patients due to the randomized location of thermal injuries. High plasma levels of alpha1-acid glycoprotein with major affinity to basic drugs, especially lidocaine, have been observed in these patients. This report shows how intermittent peripheral regional anesthesia and analgesia with high lidocaine doses may be useful in i...

متن کامل

Analgesic effects of lidocaine-ketorolac compared to lidocaine alone for intravenous regional anesthesia

Background: Intravenous regional anesthesia is a simple and reliable method for upper extremity surgery. In order to increase the quality of blocks and reduce the amount of pain, many drugs are used with lidocaine. In this study, the effect of ketorolac-lidocaine in intravenous regional anesthesia was investigated. Methods: 40 patients undergoing elective upper limb with America Society of Ane...

متن کامل

Comparison of blood pressure measurements on the upper and lower extremities during spinal anesthesia

Introduction: During spinal anesthesia, measurement of blood pressure is often obtained by an indirect method using an inflatable cuff on the upper arm. The relationship between the blood pressure measurements at the two sites in patients undergoing spinal anesthesia is unclear. This study was designed to evaluate the difference observed in systolic blood pressure (SBP) taken from the upp...

متن کامل

Cement burn: an occupational disease with favorable outcome. Case report.

We present the case of a 54-year-old patient with a thermal cement burn. This rare case is a localised occupational chemical cement burn on the lower limbs, with no systemic involvement and favourable outcome. The lesion was induced by prolonged contact of the skin with cement and water during hot summer days.

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:

دوره 1  شماره 

صفحات  -

تاریخ انتشار 2012