Why the study?
Major trauma is typically managed in specialized centers, but logistical needs or initial stabilization may require management in non-trauma-equipped hospitals.
Opioid-free regional anesthesia can be successfully used for major orthopedic trauma surgery in patients with severe cardiovascular and respiratory comorbidities.
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Supports opioid-free regional anesthesia feasibility in high-risk trauma; leaves open need for prospective trials before practice change.
Major trauma is bound to be managed in highly specialized centers. Due to logistics needs or due to an initial clinical stabilization, these patients happen to be managed in hospitals that are not fully equipped for trauma. We handled a patient, major trauma to dynamics following a high-speed collision between two cars in which she was behind the wheel. The patient was also complex due to cardiovascular and respiratory comorbidities. After ‘ABCDE’ and radiological evaluation, the patient was managed in our hospital with ICU recovery and multiple orthopedic interventions to which she was subjected with neuraxial and peripheral regional anesthesia. The patient was managed successfully and with excellent pain control. The risks associated with her comorbidities were limited to a minimum and she was discharged for rehabilitation 5 days after the operations.
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Golino et al. (2023) studied this question.
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