Regional Anesthesia for Urgent Reconstructive Surgery

Abstract

In polytrauma patients, the primary goal is to administer early resuscitation and effective analgesia with medications or techniques, which minimally affect the patient’s physiology. Adequate pain control will reduce posttraumatic stress disorder and facilitate in early functional recovery and better wound healing. Most of these polytrauma patients are hemodynamically unstable and require anesthesia and analgesia with techniques that produce minimum hemodynamic derangements; these techniques depend on the severity of trauma. The complexity of the surgery varies from primary closure to free flap reconstruction. More complicated injuries with larger tissue loss require free flap cover for better wound healing and optimal functional outcome. Optimum care of flap is an important part of perioperative management to prevent flap failure. Regional anesthesia has been proven to prevent flap failure by increasing perfusion to injured area by blocking local sympathetic system and minimizing pain-induced vasospasm. Postoperative prevention of hypothermia maintaining normocarbia plays a vital role in maintaining perfusion of free flap and prevention of flap failure. Regional anesthesia allows safe management of these patients.