Biomaterial Database

Evolving compartment syndrome not masked by a continuous peripheral nerve block: evidence-based case management. 2012

Benjamin J Walker, and Kenneth J Noonan, and Adrian T Bosenberg

Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA. bjwalker2@anesthesia.wisc.edu

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.

UI	MeSH Term	Description	Entries
D009407	Nerve Block	Interruption of NEURAL CONDUCTION in peripheral nerves or nerve trunks by the injection of a local anesthetic agent (e.g., LIDOCAINE; PHENOL; BOTULINUM TOXINS) to manage or treat pain.	Chemical Neurolysis,Chemodenervation,Nerve Blockade,Block, Nerve,Blockade, Nerve,Blockades, Nerve,Blocks, Nerve,Chemical Neurolyses,Chemodenervations,Nerve Blockades,Nerve Blocks,Neurolyses, Chemical,Neurolysis, Chemical
D003161	Compartment Syndromes	Conditions in which increased pressure within a limited space compromises the BLOOD CIRCULATION and function of tissue within that space. Some of the causes of increased pressure are TRAUMA, tight dressings, HEMORRHAGE, and exercise. Sequelae include nerve compression (NERVE COMPRESSION SYNDROMES); PARALYSIS; and ISCHEMIC CONTRACTURE. FASCIOTOMY is often used to decompress increased pressure and eliminate pain associated with compartment syndromes.	Compartment Syndrome
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328	Adult	A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available.	Adults
D055317	Evidence-Based Practice	A way of providing health care that is guided by a thoughtful integration of the best available scientific knowledge with clinical expertise. This approach allows the practitioner to critically assess research data, clinical guidelines, and other information resources in order to correctly identify the clinical problem, apply the most high-quality intervention, and re-evaluate the outcome for future improvement.	Evidence-Based Health Care,Evidence Based Health Care Management,Evidence Based Healthcare Management,Evidence Based Management, Health Care,Evidence Based Management, Healthcare,Evidence-Based Healthcare,Evidence Based Health Care,Evidence Based Healthcare,Evidence Based Practice,Evidence-Based Health Cares,Evidence-Based Healthcares,Health Care, Evidence-Based,Health Cares, Evidence-Based,Healthcare, Evidence-Based,Healthcares, Evidence-Based
D057210	Delayed Diagnosis	Non-optimal interval of time between onset of symptoms, identification, and initiation of treatment.	Diagnosis Delay,Late Diagnosis,Delayed Diagnoses,Diagnosis Delays,Diagnosis, Delayed,Diagnosis, Late,Late Diagnoses