[Locoregional anesthesia for injuries of the lower limbs].
Isolated lower limb injuries are very common; difficulties for emergency anaesthesia may come from full stomach and drug interferences. The outcome of geriatric-fractured hip is influenced neither by a preoperative delay shorter than 48 hours, nor by the choice of anaesthetic technique; Nevertheless the use of acrylic cement is associated with an increased early mortality rate in hemiarthroplasties. Regional anaesthesia is the best choice for stable patients with a limited peripheral injury; The technique must be adapted to the pain induced by fracture; sitting position is useful for puncture. Spinal anaesthesia using 0.5% plain bupivacaine produces a block quickly achieved, not influenced by posture, allowing surgical installation and procedures. Postoperative analgesia using local anaesthetics may obscure symptoms of compartment syndrome which occasionally complicate tibial and femoral nailing.
Barré
J
J
Hôpital Maison Blanche, Reims.
Lefort
P
P
Payen
M
M
D000367:Age Factors; D000765:Anesthesia, Conduction / Q000379:methods*; D004630:Emergencies; D006801:Humans; D007869:Leg Injuries / Q000601:surgery*