[Regional anaesthesia in patients with lower limb injury]

Almost all surgical procedures following injury can be provided in peripheral regional anaesthesia or spinal anaesthesia - under consideration of specific contraindications. The majority of injuries at the lower limb are associated with severe pain and immobilization during the postoperative phase. Moreover, opioids are often required which are related to nausea, vomiting and impairment of vigilance. For avoidance of those side effects, regional anaesthesia techniques should be considered as a more effective approach with a better profile of side effects. Hip and proximal femur fractures are more frequent in elder patients with a corresponding high morbidity. Therefore anaesthesia is challenging in those patients. Even injuries of the long bones - like the femur and the tibia - are causing severe pain, therefore an appropriate concept for acute pain therapy is required. Moreover, for injuries with affection of bony joint-structures (i. e. knee, ankle, calcaneus) and marked soft-tissue injuries continuous regional anaesthesia techniques could provide advantages during acute pain therapy.