Trauma is a major cause of morbidity and mortality worldwide. Each year more than 100,000 deaths in the United States and about 8?/o of all deaths worldwide are caused by traumatic injury [1]. It is the leading cause of death in persons younger than 30 years. Anesdiesia for trauma patients is one of the greatest challenges in anesdiesia. Critically ill patients must be treated whose history, status, and injuries are not well known. The pain management of a trauma patient, with their specific physical and emotional experience, imposes additional demands to anesthesiologists and critical care specialists. Many factors in the management of the trauma victim (hemody-namic fluctuations, respiratory depression, and level of consciousness) contribute to the difficulties faced in the pain control of these patients. In addition, the consequences of inadequate pain management after an injury are more than just psychologic. Acute pain is known to potentiate the physiologic stress response to trauma. The tissue damage and the dynamic of the central nervous system can engage mechanisms and create chronic pain problems that outlast the period of healing. Study results indicate that adequate analgesia is associated with improved results, whereas inadequate analgesia is associated with adverse outcomes [2-6]. Inadequate treatment of pain is reported to result in chronic pain syndromes in 69% of patients [7]. Unfortunately, trauma and orthopedic surgeons often underestimate the potential benefits of regional anesdiesia and analgesia.
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