ABSTRACT
Rib fractures and flail chest could be fatal if gas exchange is impaired. Efficient pain relief with continuous thoracic epidural analgesia allows a good physiotherapy management without central sedation and impairment of cough reflex, this prevents pulmonary atelectasis and infection. Eighteen patients/19 were treated with success in spite of flail chest, chronic obstructive pulmonary disease and minor pulmonary contusion. Intermittent positive pressure ventilation must be reserved to severe pulmonary contusion and other crushing injuries of the chest as bronchial or great vessels ruptures.
Subject(s)
Anesthesia, Epidural/methods , Flail Chest/therapy , Pain/drug therapy , Rib Fractures/therapy , Thoracic Injuries/therapy , Adult , Aged , Bupivacaine/administration & dosage , Humans , Male , Middle AgedABSTRACT
Accidents in children can occur at any moment of the day. A child has rarely an empty stomach and it is very difficult to determine when he ate or drank for the last time. The stress of the accident can slow the digestion and even stop completely. Waiting for 6 hours will not reduce the risk of inhalation of gastric contents during general anesthesia. Pain and anxiety often present with anatomical deformation may be the cause of panic that should be promptly appeased. For these reasons, there has been an increase in interest in the use of nerve block techniques in children as has been the case in adults. We carry on Brachial Plexus Blocks and Epidural Blocks.
