Integrated Methodology for the Application of Regional Anesthesia: A Seamless Analgesia Protocol from the Prehospital to the In-Hospital Phase

Dobrenko Olga

Citation: Dobrenko Olga, "Integrated Methodology for the Application of Regional Anesthesia: A Seamless Analgesia Protocol from the Prehospital to the In-Hospital Phase", Universal Library of Medical and Health Sciences, Volume 02, Issue 04.

Copyright: This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

This methodology constitutes a comprehensive, standardized protocol designed to ensure continuity of analgesia for patients, primarily those with extremity trauma, throughout the entire care pathway, from the moment of first aid in the prehospital setting to completion of treatment in the hospital. The persistent problem of fragmented analgesia, typified by inadequate pain therapy (oligoanalgesia) delivered by emergency medical services (EMS) and the subsequent loss of continuity upon transfer to the emergency department, precipitates pain escalation, a cascade of pathophysiological stress responses, and a heightened risk of complications such as delirium and chronic pain. The objective is to present a systematic, reproducible, integrated methodology that guarantees a seamless transition between care phases. Scientific novelty lies mainly in a developed joint diagnostic-therapeutic algorithm that includes both prehospital and in-hospital anesthesiological phases. Indications and contraindications, as well as ultrasound-guided methods for performing core blocks (femoral nerve block and fascia iliaca block), are described and interpreted in a systematic way as part of this study. The remaining chapters cover hospital admission, conversion of the single-shot blockade to a catheter-based technique, and the principles of regional anesthesia as part of multimodal analgesia. The key to the book’s coherence is the adoption of a communication/data transfer protocol, IMIST-RA, that the author adapted from standard handover protocols to regional anesthesia-specific features. It can lead to better clinical outcomes, greater patient satisfaction, and a more optimized use of resources.


Keywords: Prehospital Regional Anesthesia, Seamless Continuity of Analgesia, IMIST-RA Data Handover Protocol, Ultrasound Guidance, Perineural Catheter.

Download doi https://doi.org/10.70315/uloap.ulmhs.2024.0204006