title: Regional anesthesia for trauma outside the operating theatre.
abstract: OBJECTIVE
  Pain management in the trauma patient can be challenging, especially outside the operating room setting. Traditional analgesics such as opioids and NSAIDs are also problematic in trauma care. In this review, the use of regional anesthetic techniques outside the operating theatre is discussed.
  
  
  RESULTS
  Regional anesthesia is an increasing but still underutilized clinical tool for the trauma patient outside the operating room. Regional anesthesia provides well tolerated and effective analgesia and anesthesia for many indications in the trauma setting including hip fracture, reduction of joint dislocation, wound debridement, laceration repair, and multiple rib fractures. Its use can increase safety and resource allocation in emergency departments. Performance of peripheral nerve blocks, especially with ultrasound, is amenable in various medical environments with minimal training.
  
  
  CONCLUSIONS
  Pain is often poorly managed in the trauma patient. In addition to quality analgesia, regional anesthesia provides a variety of benefits in the trauma setting outside the traditional operating room setting. While further utilization requires increased training and structural changes, existing tools such as ultrasound are removing barriers to the widespread use of peripheral nerve block techniques across multiple disciplines.
authors.affiliation: St. Luke's-Roosevelt Hospital Center, Department of Anesthesiology, New York, New York 10025, USA.
authors.forename: Jason J
authors.initials: JJ
authors.lastname: Choi
authors.forename: Emily
authors.initials: E
authors.lastname: Lin
authors.forename: Jeff
authors.initials: J
authors.lastname: Gadsden
mesh_terms: D000765:Anesthesia, Conduction / Q000379:methods*; D004636:Emergency Service, Hospital; D006620:Hip Fractures / Q000601:surgery; D006801:Humans; D009407:Nerve Block / Q000379:methods; D012253:Rib Fractures / Q000601:surgery; D012783:Shoulder Dislocation / Q000601:surgery; D014947:Wounds and Injuries / Q000601:surgery*