الفهرس | Only 14 pages are availabe for public view |
Abstract Thoracic injury continues to be a significant cause of death and complications in the trauma population. A major part can be attributed directly to impaired pulmonary mechanics secondary to the pain associated with chest-wall injury. Therefore, adequate control of chest-wall pain is imperative in the management of these injuries, because splinting and atelectasis can lead to pulmonary complications. Pain limits once ability to cough and breath deeply, resulting in sputum retention, atelectasis, and a reduction in vital capacity and functional residual capacity (FRC). These factors inturn result in decreased lung compliance, ventilation perfusion mismatch, hypoxemia, and respiratory distress. Consequently, several different strategies of pain control have been employed, including intravenous narcotics, intercostal nerve blocks (ICNB), pleural infusion catheters, paravertebral blocks and epidural analgesia. |