title: Bedside fasciotomy under local anesthesia for acute compartment syndrome: a feasible and reliable procedure in selected cases.
abstract: BACKGROUND
  Fasciotomy for compartment syndrome is an emergent procedure that is usually done in the operating theater under general anesthesia. Delay in performing the procedure can lead to worse outcome. Various reasons can cause delay in performing the surgery. Bedside fasciotomy under local anesthesia can be done in these cases to avoid delay in compartment release.
  
  
  METHODS
  This was a retrospective study of 34 cases of acute compartment syndrome for which fasciotomy was done at the bedside under local anesthesia. The minimum follow-up period was 6 months.
  
  
  RESULTS
  All patients had immediate and marked improvement in pain. Thirty-three patients regained their normal muscle strength. Thirty-two patients regained normal range of motion of adjacent joints. One patient developed flexion contracture of the great toe. There was no deep infection, chronic osteomyelitis, or amputation. Superficial wound infection was noted in three patients; one patient had persistent foot drop.
  
  
  CONCLUSIONS
  Bedside fasciotomy under local anesthesia is a feasible, safe, and effective choice for treating compartment syndrome in patients with delayed presentation or those with anticipated delay to undergo surgery in the operating theater under general or regional anesthesia. The results of this study are encouraging, as all wounds healed satisfactory and there were no cases of deep infections. The formal release of compartments in the operating room under general anesthesia continues to be the standard of care. This is the first description in the literature for bedside fasciotomy under local anesthesia with a relatively large number of patients.
authors.affiliation: Department of Orthopedic Surgery, University of Toledo Medical Center, Toledo, OH, USA.
authors.forename: Nabil A
authors.initials: NA
authors.lastname: Ebraheim
authors.forename: Amr A
authors.initials: AA
authors.lastname: Abdelgawad
authors.forename: Molly A
authors.initials: MA
authors.lastname: Ebraheim
authors.forename: Sreenivasa R
authors.initials: SR
authors.lastname: Alla
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000379:methods*; D003161:Compartment Syndromes / Q000601:surgery*; D000071938:Fasciotomy; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult