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Kompartmentsyndrom och nervblockad?

Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did

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Page 1: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did

Kompartmentsyndrom och nervblockad?

Page 2: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did

Fall # 1

Page 3: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did
Page 4: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did
Page 5: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did

Fall # 2

Page 6: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did
Page 7: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did
Page 8: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did
Page 9: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did

Fall # 3

Page 10: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did

Fall # 3

Page 11: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did

Fall # 1

Fall # 2

Fall # 3

Page 12: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did

Fraktur/Krosskada

Compartmentrisk

Svår smärta

Page 13: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did

Svår smärta

Page 14: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did
Page 15: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did
Page 16: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did

Smärtanalys!

Page 17: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did

Kompartmentsyndrom?

Page 18: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did

Ja = Operation Nej = Inte operation

Kompartmentsyndrom?

Page 19: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did

Ja = Operation Nej = Inte operation

Kompartmentsyndrom?

Page 20: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did

Ja = Operation Nej = Inte operation

Smärtlindring? Smärtlindring?

Kompartmentsyndrom?

Page 21: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did

Ja = Operation Nej = Inte operation

Smärtlindring?

Page 22: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did

OpioiderLokalanestetika

Page 23: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did

Angreppspunkter

Page 24: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did
Page 25: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did

Aja baja?

Page 26: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did

Aja baja?

Page 27: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did

Aja baja?

Soberon 2016

Cometa 2011

AAOS 2018

Page 28: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did
Page 29: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did
Page 30: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did

Jajemän!

Page 31: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did

Jajemän!

Driscoll 2016

Klucka 2017

ESRA guidelines - Lönnqvist 2017

Page 32: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did
Page 33: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did
Page 34: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did

Steg för steg…

Page 35: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did

Singel vs kateter?

Page 36: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did

Singel vs kateter?

Page 37: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did

Stark eller svag?

Page 38: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did

Stark eller svag?

Page 39: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did

Blandningar?

Page 40: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did

Blandningar?

Page 41: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did

Övervakning

Page 42: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did

Övervakning

Page 43: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did

Ropivacain

2mg/ml

Infusion+bolus

Övervakning

Page 44: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did
Page 45: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did

Fall # 2

Fall # 1

Fall # 3

Infraklavikulärplexusblockad

Distal ischiadicus(popliteablockad)

Proximal ischiadicus(subglutealblockad)

Page 46: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did

Kommunikation!

Page 47: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did
Page 48: Kompartmentsyndrom och nervblockad? · FOOT & ANKLE SOCIETY Dynamic. Decisive. Dedicated. Pain Medicine 2011; 12: 823-828 Wdey ,Deriodicals, Inc. ACUTE PAIN SECTION Case Reports Did

Andreas Wiklund

Överläkare

Flödesledare Ortopedi

Anestesikliniken

Capio S:t Görans sjukhus

Stockholm