Evolving compartment syndrome not masked by a continuous peripheral nerve block: evidence-based case management

Regional Anesthesia and Pain Medicine
Benjamin J WalkerAdrian T Bosenberg

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.

References

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Citations

May 16, 2013·Current Opinion in Anaesthesiology·Jason J ChoiJeff Gadsden
Aug 19, 2015·Journal of Pediatric Nursing·Cheryl MeleKaren Goldschmidt
Sep 12, 2013·Acta Anaesthesiologica Scandinavica·H Munk-Andersen, T K Laustrup
May 26, 2017·Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia·Jozef KluckaMartin Repko
Oct 11, 2016·British Journal of Hospital Medicine·Mohammed Haque, Gary Yap
Oct 21, 2017·Regional Anesthesia and Pain Medicine·André P Boezaart, Hari K Parvataneni
Jan 13, 2019·Regional Anesthesia and Pain Medicine·De Q TranJoseph M Neal
Feb 9, 2019·Minerva anestesiologica·Theodosios SaranteasRizos Souvatzoglou
Oct 10, 2013·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Tomas J Kucera, André P Boezaart
Jan 9, 2015·Journal of Pediatric Orthopedics. Part B·Chris D GloverMehernoor Watcha
Jan 10, 2018·Anaesthesia·D W HewsonJ G Hardman
Jun 20, 2021·Regional Anesthesia and Pain Medicine·Andre P BoezaartMiguel A Reina
Jul 1, 2021·Regional Anesthesia and Pain Medicine·Tim DwyerRichard Brull

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