Regional Anesthesia Strategies in Orthopedic Trauma.

Abstract

Purpose: Orthopedic trauma patients have variable analgesic and anesthetic requirements dependent on injury pattern, severity, and comorbidities. Inadequate pain control can delay rehabilitation, prolong hospitalization, and contribute to chronic pain and opioid dependence. This review aims to summarize contemporary regional anesthesia (RA) strategies in orthopedic fracture care and highlight their indications, benefits, and limitations in the trauma setting.

Methods: A comprehensive literature search was conducted across PubMed, Google Scholar, and Web of Science to identify relevant studies on regional anesthesia techniques in orthopedic trauma. Search terms included "regional anesthesia," "peripheral nerve block," "orthopedic trauma," "fracture," "perioperative analgesia," and "multimodal analgesia." Following initial broad search, focused secondary searches were conducted for specific regional techniques. Review articles, randomized controlled trials, prospective and retrospective cohort studies, and landmark technique descriptions were all considered.

Results: Advances in ultrasound-guided regional anesthesia have significantly improved the precision, safety, and reliability of neuraxial and peripheral nerve block techniques. RA has been associated with superior early pain control, reduced opioid consumption, improved patient satisfaction, and facilitation of early mobilization when compared to systemic analgesia or general anesthesia alone. Although concerns persist regarding hemodynamic instability, masking of acute compartment syndrome, and peripheral nerve injury, current evidence supports the use of RA when appropriately indicated.

Conclusion: RA is an increasingly important component of multimodal analgesia in orthopedic trauma care. Familiarity with available techniques, anatomic considerations, and injury-specific applications allows orthopedic surgeons to collaborate effectively with anesthesia teams and optimize perioperative pain management. These strategies can improve functional recovery while minimizing opioid requirements.