Regional Anesthesia in the Field for Trauma Victims

Vietor, Robert; Buckenmaier, Chester

doi:10.1016/j.anclin.2021.02.006

Cited by 6 publications

(9 citation statements)

References 63 publications

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“…2 Vietor et al recommend using modern USG machines for safer and more effective regional anesthesia. 5 In the absence of ultrasound, consider landmark-based nerve stimulation with awareness of risks and available resources. 2,5 USG-guided nerve blocks can be a safe and effective option in selected patients and fulfill most of the criteria of the ideal option, as discussed by Valence et al 1,4,5 Regional blocks like hematoma blocks can be a safe alternative and can be performed without USG.…”

Section: Doi: 101177/10806032231223756mentioning

confidence: 99%

“…5 In the absence of ultrasound, consider landmark-based nerve stimulation with awareness of risks and available resources. 2,5 USG-guided nerve blocks can be a safe and effective option in selected patients and fulfill most of the criteria of the ideal option, as discussed by Valence et al 1,4,5 Regional blocks like hematoma blocks can be a safe alternative and can be performed without USG. Blunt trauma chests (BTC) are commonly reported in MCI due to earthquakes, as reported recently in Turkey.…”

Section: Doi: 101177/10806032231223756mentioning

confidence: 99%

“…8 For regional anesthesia in MCI, the minimum dose required to get the desired effect must be considered, and overdose must be avoided to prevent complications like local anesthesia systemic toxicity (LAST). 4,5 Ketamine is an ideal agent, but its dose is not discussed. 1 Subdissociative dose ketamine (0.3 mg/kg) is ideal due to its minimal side effects.…”

Section: Doi: 101177/10806032231223756mentioning

confidence: 99%

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In response to “time to reconsider analgesia in mass casualty incidents” by Valence et al.

Mohanty,

Das,

Barik

et al. 2024

Wilderness & Environmental Medicine

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The recent exchange of letters to the editor, in response to "Time to Reconsider Analgesia in Mass Casualty Incidents" by de Valence and Suppan, 1 has illuminated critical aspects of pain management during mass casualty incidents (MCIs) and brings forth several noteworthy considerations.In all the correspondence, there is an echoing of the overlooked need to address the prioritization of analgesia in injury management, particularly in light of devastating events such as the earthquakes in Turkey, emphasizing the need for timely and effective pain relief in the aftermath of natural disasters. One letter highlights the importance of regional anesthesia as a significant component of analgesia, underscoring its growing relevance in multimodal analgesia management. 2 Another letter proposes the adoption of a new multi-casualty pneumonic triage: START-A. 3 A final letter adds to the discourse by correcting an oversight regarding the availability of Methoxyflurane, stating its approval in Canada since 2018. 4 These clarifications are a valuable update to the original article and underscore the global applicability of specific analgesic options.The main article discusses the historical oversight of analgesia in mass casualty incidents and emphasizes the necessity of reassessing traditional approaches. It advocates for incorporating new, safe, and efficient methods for administering quality analgesia, challenging the prevailing notion of low-priority status for pain management in MCIs. The authors aptly argue that poor pain management in trauma victims can hinder evacuation efforts and contribute to the development of chronic pain and post-traumatic stress disorder. They propose implementing innovative analgesic methods that are easily administered, with rapid onset and minimal need for monitoring, to bridge the gap in providing early pain control during MCIs.These letters and the main article collectively contribute to the ongoing dialogue on the critical role of analgesia in mass casualty incidents. They prompt reevaluating existing paradigms and advocating for integrating novel, efficient, and safe analgesic modalities to enhance patient care in the challenging and dynamic context of MCIs.

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Section: Doi: 101177/10806032231223756mentioning

confidence: 99%

Section: Doi: 101177/10806032231223756mentioning

confidence: 99%

Section: Doi: 101177/10806032231223756mentioning

confidence: 99%

See 1 more Smart Citation

In response to “time to reconsider analgesia in mass casualty incidents” by Valence et al.

Mohanty,

Das,

Barik

et al. 2024

Wilderness & Environmental Medicine

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“…In other parts of the world, physicians who are highly trained in resuscitative and trauma medicine (often anesthesiologists) accompany the team for retrievals by ambulance or helicopter [3,24,47]. When clinicians are part of on-scene rescue RA interventions can be implemented earlier [48 ▪ ]. This can offer superior analgesia, attenuation of stress response, increased patient alertness, improved patient cooperation, ease of transport, avoidance of systemic side-effects while improving protection from the development of chronic pain conditions [1,49,50].…”

Section: Part 3: Special Considerationsmentioning

confidence: 99%

“…This can offer superior analgesia, attenuation of stress response, increased patient alertness, improved patient cooperation, ease of transport, avoidance of systemic side-effects while improving protection from the development of chronic pain conditions [1,49,50]. As demonstrated by several studies investigating battlefield injuries and early patient evacuation, the benefits of earlier optimized pain control may have long-term benefits for the patient [3,12,48 ▪ ].…”

Section: Part 3: Special Considerationsmentioning

confidence: 99%

Regional anesthesia and analgesia for trauma: an updated review

Torrie¹

2022

Current Opinion in Anaesthesiology

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Purpose of reviewThis narrative review is an updated summary of the value of regional anesthesia and analgesia for trauma and the special considerations when optimizing pain management and utilizing regional analgesia for acute traumatic pain. Recent findingsIn the setting of the opioid epidemic, the need for multimodal analgesia in trauma is imperative. It has been proposed that inadequately treated acute pain predisposes a patient to increased risk of developing chronic pain and continued opioid use. Enhanced Regional Anesthesia techniques along with multimodal pain therapies is thought to reduce the stress response and improve patient's short-and long-term outcomes.

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