Case Reports
5 August 2025
Vol. 1 No. 1 (2023)
Management of a road major trauma in a spoke hospital: a report of opioid-free anesthesia in a minimally invasive orthopedic surgery
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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Major trauma is bound to be managed in highly specialized centers. Due to logistics needs or due to an initial clinical stabilization, these patients happen to be managed in hospitals that are not fully equipped for trauma. We handled a patient with major trauma to the dynamics following a high-speed collision between two cars in which she was behind the wheel. The patient was also complex due to cardiovascular and respiratory comorbidities. After ‘ABCDE’ and radiological evaluation, the patient was managed in our hospital with ICU recovery and multiple orthopedic interventions to which she was subjected with neuraxial and peripheral regional anesthesia. The patient was managed successfully and with excellent pain control. The risks associated with her comorbidities were limited to a minimum and she was discharged for rehabilitation 5 days after the operations.
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Galvagno SM Jr, Nahmias JT, Young DA. Advanced Trauma Life Support® update 2019: management and applications for adults and special populations. Anesthesiol Clin 2019;37:13-32. DOI: https://doi.org/10.1016/j.anclin.2018.09.009
Payal P, Sonu G, Anil GK, Prachi V. Management of polytrauma patients in emergency department: An experience of a tertiary care health institution of northern India. World J Emerg Med 2013;4:15-9. DOI: https://doi.org/10.5847/wjem.j.issn.1920-8642.2013.01.003
Talley CL, Campbell BT, Jenkins DH, et al. Recommendations from the American College of Surgeons Committee on Trauma's Firearm Strategy Team (FAST) Workgroup: Chicago Consensus I. J Am Coll Surg 2019;228:198-206. DOI: https://doi.org/10.1016/j.jamcollsurg.2018.11.002
Chen DX, Yang L, Ding L, et al. Perioperative outcomes in geriatric patients undergoing hip fracture surgery with different anesthesia techniques: a systematic review and meta-analysis. Medicine (Baltimore) 2019;98:e18220. DOI: https://doi.org/10.1097/MD.0000000000018220
Eamer G, Taheri A, Chen SS, et al. Comprehensive geriatric assessment for older people admitted to a surgical service. Cochrane Database Syst Rev 2018;1:CD012485. DOI: https://doi.org/10.1002/14651858.CD012485.pub2
Thompson L, Hill M, Lecky F, Shaw G. Defining major trauma: a Delphi study, Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2021;29:63. DOI: https://doi.org/10.1186/s13049-021-00870-w
Meinberg E, Agel J, Roberts C, et al. Fracture and Dislocation Classification Compendium–2018. J Orthop Trauma 2018;32. DOI: https://doi.org/10.1097/BOT.0000000000001063
Baker SP, O'Neill B, Haddon W Jr, Long WB. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma 1974;14:187-96. DOI: https://doi.org/10.1097/00005373-197403000-00001
Kovalenko B, Bremjit P, Fernando N. Classifications in Brief: Tönnis Classification of Hip Osteoarthritis. Clin Orthop Relat Res 2018;476:1680-4. DOI: https://doi.org/10.1097/01.blo.0000534679.75870.5f
Kietaibl S, Ferrandis R, Godier A, et al. Regional anaesthesia in patients on antithrombotic drugs: Joint ESAIC/ESRA guidelines. Eur J Anaesthesiol 2022;39:100-32. DOI: https://doi.org/10.1097/EJA.0000000000001600
Saracco M, Smimmo A, De Marco D, et al. Surgical approach for fracture of distal humerus: posterior vs lateral. Orthop Rev (Pavia) 2020;12:8664. DOI: https://doi.org/10.4081/or.2020.8664
Saracco M, Fulchignoni C, Fusco F, Logroscino G. Which surgical treatment is preferable in humeral diaphyseal fractures? A systematic review. Orthop Rev 2022;14:37575. DOI: https://doi.org/10.52965/001c.37575
Holdgate A, Shepherd SA, Huckson S. Patterns of analgesia for fractured neck of femur in Australian emergency departments. Emerg Med Australas 2010;22:3–8. DOI: https://doi.org/10.1111/j.1742-6723.2009.01246.x
Berben SAA, Meijs THJM, van Dongen RTM, et al. Pain prevalence and pain relief in trauma patients in the Accident and Emergency department. Injury 2008;39:578–85. DOI: https://doi.org/10.1016/j.injury.2007.04.013
Benyamin R, Trescot AM, Datta S, et al. Opioid complications and side effects. Pain Physician 2008;11:S105-20. DOI: https://doi.org/10.36076/ppj.2008/11/S105
O'Connell KM, Quistberg DA, Tessler R, et al. Decreased risk of delirium with use of regional analgesia in geriatric trauma patients with multiple rib fractures. Ann Surg 2018;268:534-40. DOI: https://doi.org/10.1097/SLA.0000000000002929
Kumar G, Kumar Bhoi S, Sinha TP, Paul S. Erector spinae plane block for multiple rib fracture done by an Emergency Physician: A case series. Australas J Ultrasound Med 2020;24:58-62. DOI: https://doi.org/10.1002/ajum.12225
Vozoris NT, Wang X, Fischer HD, et al. Incident opioid drug use and adverse respiratory outcomes among older adults with COPD. Eur Respir J 2016;48:683-93. DOI: https://doi.org/10.1183/13993003.01967-2015
Gadsden J, Warlick A. Regional anesthesia for the trauma patient: improving patient outcomes. Local Reg Anesth 2015;8:45–55. DOI: https://doi.org/10.2147/LRA.S55322
Stamenkovic DM, Geric V, Slavkovic Z, et al. Combined spinal-epidural analgesia vs. intermittent bolus epidural analgesia for pain relief after major abdominal surgery. A prospective, randomised, double-blind clinical trial. Int J Clin Pract 2008;62:255-62. DOI: https://doi.org/10.1111/j.1742-1241.2007.01642.x
Stone MB, Wang R, Price DD. Ultrasound-guided supraclavicular brachial plexus nerve block vs procedural sedation for the treatment of upper extremity emergencies. Am J Emerg Med 2008;26:706–10. DOI: https://doi.org/10.1016/j.ajem.2007.09.011
How to Cite
Management of a road major trauma in a spoke hospital: a report of opioid-free anesthesia in a minimally invasive orthopedic surgery. (2025). Advances in Anesthesia and Pain Medicine, 1(1). https://doi.org/10.4081/aapm.16.
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