Regional anaesthesia in compartment syndrome

The Austrian science fund (FWF) has granted an in depth investigation on Compartment Syndrome (CS) of the limb, a very serious and potentially dangerous medical condition. If being undiagnosed, it can lead to loss of function or even loss of the extremity affected. The study will be conducted as a collaboration between the LBI Trauma, Vienna and the Department of Anesthesia and Intensive Care Medicine at the AUVA Trauma Hospital in Salzburg. The leading pathophysiological mechanism behind CS is a breakdown in the oxygen-supply of the affected limb caused by trauma or ischemia. Muscular tissue is embedded in tight connective tissue sheaths, the so-called fascia. A CS develops if the pressure within this compartment exceeds the blood pressure in the supporting vessels and thus blood flow is stopped. Regional Anesthesia, on the other hand, shows a vasodilative effect and enhances perfusion in the dependent area. To date, experimental data on the influence of Regional Anesthesia on CS is lacking. Until today it is not known whether regional anesthesia worsens the effect of reduced perfusion or not. In clinical practice, pain therapy after trauma or surgery plays an important role. Not only patient comfort but also postoperative outcomes can be negatively influenced by pain. Therefore, it is of major importance to apply methods which have proven effective in easing pain. Regional anesthesia is well known to reduce pain in the dependent limb to a minimum. Many orthopedic experts decide against regional anesthesia in patients suffering from CS with the aim not to delay its diagnosis and not to deteriorate the clinical course of CS. To improve the evidence for the question whether to use RA or not in CS-patients, we will perform a prospective, randomized double blinded (operator and investigator) study. In our investigation we will quantify the influence of the application of Regional Anesthesia on the development of the Compartment Syndrome in an animal model over time.The study is led by anaesthesiologist Dr. Gerhard Fritsch and is coordinated by Dr. Johannes Zipperle from the LBI Trauma. During the whole experiment ECG, Oxygen-saturation, invasive arterial pressure and continuous pressure monitoring within the compartment will be performed. A series of laboratory analyses of parameters retrieved from the serum wil be contucted. There will be continuous monitoring of oxygen supply with a microperfusion device.Investigated parameters will be statistically analyzed with the aim to reveal differences between groups. Resulting from this project the investigators expect a contribution to the knowledge about the use of Regional Anesthesia in patients suffering from Compartment Syndrome.

FWF project on Compartment Syndrome and Regional Anesthesia The Austrian science fund (FWF) has granted an in depth investigation on Compartment Syndrome (CS) of the limb, a very serious and potentially dangerous medical condition. If being undiagnosed, it can lead to loss of function or even loss of the extremity affected. The study will be conducted as a collaboration between the LBI Trauma, Vienna and the Department of Anesthesia and Intensive Care Medicine at the AUVA Trauma Hospital in Salzburg. The leading pathophysiological mechanism behind CS is a breakdown in the oxygen-supply of the affected limb caused by trauma or ischemia. Muscular tissue is embedded in tight connective tissue sheaths, the so-called fascia. A CS develops if the pressure within this compartment exceeds the blood pressure in the supporting vessels and thus blood flow is stopped. Regional Anesthesia, on the other hand, shows a vasodilative effect and enhances perfusion in the dependent area. To date, experimental data on the influence of Regional Anesthesia on CS is lacking. Until today it is not known whether regional anesthesia worsens the effect of reduced perfusion or not. In clinical practice, pain therapy after trauma or surgery plays an important role. Not only patient comfort but also postoperative outcomes can be negatively influenced by pain. Therefore, it is of major importance to apply methods which have proven effective in easing pain. Regional anesthesia is well known to reduce pain in the dependent limb to a minimum. Many orthopedic experts decide against regional anesthesia in patients suffering from CS with the aim not to delay its diagnosis and not to deteriorate the clinical course of CS. To improve the evidence for the question whether to use RA or not in CS-patients, we will perform a prospective, randomized double blinded (operator and investigator) study. In our investigation we will quantify the influence of the application of Regional Anesthesia on the development of the Compartment Syndrome in an animal model over time.The study is led by anaesthesiologist Dr. Gerhard Fritsch and is coordinated by Dr. Johannes Zipperle from the LBI Trauma. During the whole experiment ECG, Oxygen-saturation, invasive arterial pressure and continuous pressure monitoring within the compartment will be performed. A series of laboratory analyses of parameters retrieved from the serum wil be contucted. There will be continuous monitoring of oxygen supply with a microperfusion device.Investigated parameters will be statistically analyzed with the aim to reveal differences between groups. Resulting from this project the investigators expect a contribution to the knowledge about the use of Regional Anesthesia in patients suffering from Compartment Syndrome.