Metadata language
Title:
Preemptive local anesthesia in limb surgery
Author:
Subject:
local anesthesia ; postoperative pain ; preemptive anesthesia
Abstract:
Orthopedic procedures performed in upper and lower extremities are often associated with considerable postoperative pain. Preemptive local anesthesia is one of the methods of reducing the level of intensity of postoperative pain. The objective of the present doctoral dissertation that is based on four publications was the assessment of effectiveness and safety of employing preemptive operative site infiltration with a mixture of local anesthetics in selected orthopedic surgical procedures involving upper and lower extremities. The material consisted of groups of patients subjected to correction of hallux valgus type deformities, ankle arthroscopy and open reduction and internal fixation in fractures of distal radial epiphysis, in whom prior to the surgical incision the operative site was additionally infiltrated with a mixture of local anesthetics or saline. The assessment included the level of postoperative pain intensity in the initial three postoperative days, which was evaluated using the visual analogue scale (VAS), demand for additional analgesics, adverse effects of the medications, general and local complications. Preemptive local anesthesia reduces postoperative pain over the initial 24 hours following orthopedic surgery involving the extremities. It is a safe method, which reduces demand for additional analgesics. In case of fractures of the extremities, the effective ; ness of preemptive local anesthesia decreases with an increasing time lapse between the fracture and surgery.