REGIONAL ANESTHESIA AS PART OF THE RECOVERY STRATEGY IN PATIENTS WITH CHEST TRAUMA
DOI:
https://doi.org/10.11603/2414-4533.2025.3.15628Keywords:
chest injury, intercostal nerve block, thoracic epidural anesthesia, paravertebral block, regional anesthesiaAbstract
The aim of the work: analysis of modern methods of regional anesthesia, their use and effectiveness in pain relief of patients with chest injuries, as well as assessment of their role in the recovery strategy after traumatic and surgical interventions.
Materials and Methods. Scientific information databases, including PubMed, Web of Science, Embase and Cochrane Library, were used to collect relevant information. Search queries included combinations of keywords relating to regional anesthetic techniques such as «thoracic epidural blocks», «thoracic paravertebral blocks», «intercostal blocks», «fascial plane blocks», as well as terms related to chest injuries, postoperative pain and pain relief strategies («regional anesthesia», «thoracic surgery», «chest injuries», «patient treatment», «stress marks»). Only prospective randomized controlled trials were selected for analysis. The search was carried out according to the inclusion criteria. The synthesis of the results was carried out according to thematic sections revealing the main aspects of the application of regional anesthesia in the strategy of analgesia and restoration of functions after chest injuries.
Results. Despite the high effectiveness of epidural anesthesia for pain relief in various surgical interventions, this method has a number of difficulties. Thus, the technical performance of epidural anesthetics is quite difficult and can cause significant discomfort in sleepless patients. The most frequent adverse event of this method is considered to be a non-functioning block, which occurs in approximately 30% of cases. Migration or misposition of the catheter may result in unilateral or spotty blockages. Among the serious complications of the procedure, vascular injuries, paresthesias and nerve damage, which occur especially often in patients with complex anatomy, should be noted. In this regard, as an alternative to epidural anesthesia, the European Society of Thoracic Surgeons (ESTS) recommends the use of thoracic-paravertebral block (TPB) or intercostal nerve block for analgesia in thoracic surgery.
Conclusions. Among the anesthetic techniques used in chest injuries, regional techniques, in particular intercostal, paravertebral, epidural and plane block, are of important clinical importance, provide a high level of analgesia with minimal systemic impact, improve patient compliance with respiratory therapy, contribute to reducing the frequency of pneumonia and shorten the duration of hospitalization. In particular, intercostal block, as one of the most direct and targeted techniques, is effective in isolated rib fractures, allowing for rapid pain relief. Regional anesthesia is recognized as the optimal tool for effective pain relief for chest injuries, especially in conditions of polytrauma, intensive care units and thoracic surgery.
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