Regional anesthesia for shock

Lakhin R.E.

S.M. Kirov Military Medical Academy

ORCID: 0000-0001-6819-9691

Kusai A.S.

Kirov Military Medical Academy

ORCID: 0000-0002-0668-9676

Usoltsev E.A.

Military Clinical Hospital 442

ORCID: 0000-0001-6497-1429

Tsygankov K.A.

Kirov Military Medical Academy

ORCID: 0000-0002-2357-0685

Tsvetkov V.G.

Military Medical Academy

ORCID: 0000-0003-4980-597X

Shustrov V.V.

Kirov Military Medical Academy

ORCID: 0000-0001-5144-3360

Regional anesthesia for shock

Authors:

Lakhin R.E., Kusai A.S., Usoltsev E.A., Tsygankov K.A., Tsvetkov V.G., Shustrov V.V.

More about the authors

Journal: Russian Journal of Anesthesiology and Reanimatology. 2024;(1): 6‑13

DOI: 10.17116/anaesthesiology20240116

Downloaded: 819

To cite this article:

Lakhin RE, Kusai AS, Usoltsev EA, Tsygankov KA, Tsvetkov VG, Shustrov VV. Regional anesthesia for shock. Russian Journal of Anesthesiology and Reanimatology. 2024;(1):6‑13. (In Russ., In Engl.)
https://doi.org/10.17116/anaesthesiology20240116

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BACKGROUND

Intraoperative anesthesia in armed conflicts has certain features. Anesthesiologists face several objectives, i.e. stabilization of clinical status, choice of controlled method of anesthesia protecting against surgical aggression with early restoration of vital functions and spontaneous breathing. At the same time, the role of regional anesthesia in shock has not been fully discovered.

OBJECTIVE

To evaluate the effect of regional anesthesia on the need or increase in intraoperative vasopressor support in patients with hemorrhagic shock following combat trauma.

MATERIAL AND METHODS

A retrospective cohort study included 146 victims and wounded with combat trauma and hemorrhagic shock. All ones underwent surgery under anesthesia at the stage of qualified medical care during special military operation within a month.

RESULTS

Shock grade II upon admission was detected in 92 (63%) victims, grade III — in 28 (19.2%) cases, grade I — 16 (11%) cases, grade IV — 10 (6.8%) cases. Regional anesthesia was used in 73.3% of cases (mainly as a part of combined anesthesia). Regional anesthesia required initiation or increase of vasopressor support in 4 (3.7%) of patients, and 19 (17.8%) ones needed for vasopressor support after induction of general anesthesia.

CONCLUSION

The need for vasopressor support was lower in patients undergoing regional anesthetic techniques compared to general anesthesia.

Keywords:

regional anesthesia

femoral nerve block

brachial plexus block

sciatic nerve block

hemorrhagic shock

combat injury

injury

bleeding

medical service

special military operation

Authors:

Lakhin R.E.

S.M. Kirov Military Medical Academy

ORCID: 0000-0001-6819-9691

Kusai A.S.

Kirov Military Medical Academy

ORCID: 0000-0002-0668-9676

Usoltsev E.A.

Military Clinical Hospital 442

ORCID: 0000-0001-6497-1429

Tsygankov K.A.

Kirov Military Medical Academy

ORCID: 0000-0002-2357-0685

Tsvetkov V.G.

Military Medical Academy

ORCID: 0000-0003-4980-597X

Shustrov V.V.

Kirov Military Medical Academy

ORCID: 0000-0001-5144-3360

Received:

21.08.2023

Accepted:

29.09.2023

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