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Regional Anesthesia in the Critical Care Setting

  • Amir O. Elhassan
  • Harish Bangalore Siddaiah
  • Brendon M. Hart
  • Mark Ryan Jones
  • Cory A. Roberts
  • Maura Elise Jones
  • Alan David Kaye
Chapter

Abstract

The critically ill population represents the sickest and often among the most difficult to manage patients in the hospital. In this regard, often these patients are suffering from complex pathogenesis and often have pain states that are difficult to manage. Adequate pain control is essential in reducing the stress response during critical illness and providing analgesia to difficult disease states. Conventional opioid therapy runs the risk of developing respiratory depression, altered mental status, and reduced bowel function. Given all of these concerns, regional anesthesia can significantly benefit the patient significantly in the critical care environment.

As in many other clinical settings, a multimodal approach to pain control is recommended for the intensive care setting. The use of regional and neuraxial analgesia can play a significant role in this approach to achieve optimal pain relief, thereby reducing physiologic and psychologic stress. In addition, reduction in the utilization of opiate therapy decreases the risk for withdrawal syndrome, mental status changes, delirium, nausea and vomiting, and reduced gastrointestinal motility.

Keywords

Regional anesthesia Critical care Peripheral nerve blocks Epidural analgesia 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Amir O. Elhassan
    • 1
  • Harish Bangalore Siddaiah
    • 2
  • Brendon M. Hart
    • 3
  • Mark Ryan Jones
    • 4
  • Cory A. Roberts
    • 5
  • Maura Elise Jones
    • 6
  • Alan David Kaye
    • 7
  1. 1.Department of AnesthesiologyWexner Medical Center, Ohio State UniversityDublinUSA
  2. 2.Department of Anesthesiology and Critical Care MedicineLouisiana State University Health Sciences Center—ShreveportShreveportUSA
  3. 3.Department of AnesthesiologyLouisiana State University Health Sciences Center—ShreveportShreveportUSA
  4. 4.Department of Anesthesiology, Critical Care and Pain MedicineBeth Israel Deaconess Medical Center, Harvard Medical SchoolBostonUSA
  5. 5.Department of AnesthesiaTulane UniversityNew OrleansUSA
  6. 6.Department of AnesthesiologySchool of Medicine, Louisiana State University Health Sciences Center—New OrleansNew OrleansUSA
  7. 7.Department of AnesthesiologyLouisiana State University School of MedicineNew OrleansUSA

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