Affiliation:
1. Department of Liver Transplant Anaesthesia Human Care Medical Charitable Trust Manipal Hospital New Delhi India
2. Department of Anaesthesia Rao Tula Ram Memorial Hospital New Delhi India
3. Liver Intensive Care Unit Human Care Medical Charitable Trust Manipal Hospital New Delhi India
4. Department of Anaesthesia NMC Royal Hospital Dubai United Arab Emirates
Abstract
SummaryThe anaesthetic management of multiple traumatic injuries poses numerous challenges. In this report, we present the cases of two patients with polytrauma including pneumothoraces and multiple rib fractures. The first patient, a 39‐year‐old man, presented with multiple left upper limb fractures, multiple bilateral rib fractures, bilateral pneumothoraces and fractures of multiple facial and cranial bones. The second patient, a 39‐year‐old woman, presented with right‐sided radial and ulnar fractures, a right‐sided pelvic fracture, and multiple right‐sided rib fractures with an associated pneumothorax. We used ultrasound‐guided superficial cervical plexus, interscalene and supraclavicular blocks in the first case and a combined spinal and epidural after ultrasound‐guided fascia iliaca and supraclavicular blocks in the second case. In both cases, the use of multiple regional techniques allowed us to avoid the risks of general anaesthesia in patients with conservatively managed pneumothoraces.