Hadzic's Regional Anesthesia > Part VIII. Regional Anesthesia in Patients with Special Considerations > Chapter 60. Acute Compartment Syndrome of the Limb: Implications for Regional Anesthesia Xavier Sala-Blanch, MD, José De Andrés, MD, Alton Barron, MD, Paul Hobeika, MD, Adam Cohen, MD, Lakshmanasamy Somasundaram, MD

Acute Compartment Syndrome of the Limb: Implications for Regional Anesthesia: Introduction

"Compartment syndrome is an orthopedic emergency. It is an acute condition of the limbs in which the pressure of isolated or groups of compartments increases dramatically and limits local soft tissue perfusion to the point of ischemic necrosis. Regional anesthesia may mask the signs and symptoms of compartment syndrome, so practitioners should be alert to patient risk factors, clinical presentation, and management of this potentially limb-threatening condition. The musculoskeletal structures of the limbs are enclosed within compartments created by investing, inelastic sheets of fascia that have a limited ability to expand. These compartments contain skeletal muscles that form the bulk of their contents, along with the neurovascular structures that pass through the compartment. If missed, compartment syndrome¹ can be a life- and limb-threatening condition.Any condition that can reduce the volume of the compartment or increase the size of the contents of the compartment can lead to an acute compartment syndrome. Examples of factors leading to these changes are presented in Table 60–1...."