الفهرس 
EPIDURAL ANESTHESIAOnly 14 pages are availabe for public view
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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.