The problem of choosing anesthesia method for surgical interventions on the lower limbs in young patients




general anesthesia, regional anesthesia, injuries of the lower limbs, young people


The relevance of the topic is due to the prevalence of lower limbs injuries in people of working age, the complexity of the methods of their surgical treatment and the problem of finding the optimal method of anesthesia in terms of efficiency and safety.

Objective of the study: to conduct a systematic analysis of modern scientific literature data on the possibility of using anesthesia methods during surgical interventions and in the case of anesthesia for injuries of the lower limbs in people of working age.

Materials and methods. A search for scientific sources was carried out in the scientometric databases Scopus and Web of Science, Google Scholar, archives of journals using the keywords "general anesthesia", "regional anesthesia", "injuries of the lower limbs", "young people", "general anesthesia". The search depth was 8 years.

Conclusions. The problem of choosing the method of anesthesia during traumatological surgeries in people of working age has no final solution. In general, both general and regional anesthesia can be used, despite their advantages and the possibility of complications in each case. However, in clinical practice over the past decade, general anesthesia is not always the best method of pain relief. But regional methods have less effect on the vital functions of the body, and the use of ultrasound navigation and modern local anesthetics in a minimum sufficient amount makes anesthesia conduction more effective and safe. The disadvantages of regional anesthesia can be avoided by combining it with general anesthesia. However, in the available literature, there are no recommendations on the differentiated choice of the method of anesthesia for surgical interventions on the lower limbs in people of working age and the factors that influence this

Author Biographies

Marine Georgiyants, Kharkiv Medical academy of Postgraduate Education

MD, Professor

Department of Anesthesiology, Pediatric Anesthesiology and Intensive Care

Olexii Popsuishapka, Kharkiv Medical Academy of Postgraduate Education

MD, Professor

Department of Traumatology and Orthopedics

Victor Ryndenko, Kharkiv Medical Academy of Postgraduate Education

MD, Professor, Head of Department

Department of Traumatology, Anaesthesiology and Military

Sergiy Kursov, Kharkiv Medical Academy of Postgraduate Education

MD, Professor

Department of Emergency Medicine and Disaster Medicine

Volodymyr Babalian, Kharkiv Medical Academy of Postgraduate Education

PhD, Associate Professor

Department of Traumatology, Anaesthesiology and Military

Nataliia Bohuslavska, Kharkiv Medical Academy of Postgraduate Education

PhD, Assistant

Department of Anesthesiology, Pediatric Anesthesiology and Intensive Care


  1. Goudie, E. B., Duckworth, A. D., White, T. O. (2017). Hip fractures in young adults. Orthopaedics and Trauma, 31 (2), 76–85. doi:
  2. Vyshlova, I. A., Karpov, S. M., Starodubtsev, A. I. (2016). Neuroimmunological mechanisms of chronic pain syndrome. Neurology, Neuropsychiatry, Psychosomatics, 8 (2), 113–116. doi:
  3. Shostak, N. A., Pravdyuk, N. G. (2016). Pain syndrome: some diagnostic aspects. The Clinician, 10 (1), 10–11.
  4. Farr, J. N., Melton, L. J., Achenbach, S. J., Atkinson, E. J., Khosla, S., Amin, S. (2017). Fracture Incidence and Characteristics in Young Adults Aged 18 to 49 Years: A Population-Based Study. Journal of Bone and Mineral Research, 32 (12), 2347–2354. doi:
  5. Grygorieva, N. V., Vlasenko, R. O. (2017). Epidemiology and risk factors of lower limb fractures (literature review). Pain. Joints. Spine, 7 (3), 127–138. doi:
  6. Sumitani, M., Yasunaga, H., Uchida, K., Horiguchi, H., Nakamura, M., Ohe, K. et. al. (2013). Perioperative factors affecting the occurrence of acute complex regional pain syndrome following limb bone fracture surgery: data from the Japanese Diagnosis Procedure Combination database. Rheumatology, 53 (7), 1186–1193. doi:
  7. Tarbiat, M., Majidi, M., Manouchehrian, N. (2019). Frequent Spinal Anesthesia in a Patient with Traumatic Lower Extremity Injury: A Case Report. Anesthesiology and pain medicine, 9 (2), e88595. doi:
  8. Povoroznyuk, V. V., Grygorieva, N. V., Korzh, M. O., Strafun, S. S., Vaida, V. M., Klymovytsky, F. V. et. al. (2016). Epidemiology of the proximal femur fractures in ukraine: results of stop-study (system of registration of osteoporotic fractures in Ukrainian population). Trauma, 17 (5), 14–20. doi:
  9. Tsuda, T. (2017). Epidemiology of fragility fractures and fall prevention in the elderly: a systematic review of the literature. Current Orthopaedic Practice, 28 (6), 580–585. doi:
  10. Chaplynskyi, R. P., Perepelytsia, Ye. Ye., Berezka, М. I., Hariachy, Ye. V., Lytovchenko, V. О. (2017). Regional anesthesia with prolonged analgesia in treatment of multiple fractures of limbs. International Medical Journal, 1, 89–92.
  11. Beerekamp, M. S. H., de Muinck Keizer, R. J. O., Schep, N. W. L., Ubbink, D. T., Panneman, M. J. M., Goslings, J. C. (2017). Epidemiology of extremity fractures in the Netherlands. Injury, 48 (7), 1355–1362. doi:
  12. Cummings, S. R., Melton, L. J. (2002). Epidemiology and outcomes of osteoporotic fractures. The Lancet, 359 (9319), 1761–1767. doi:
  13. Ovechkin, A. M., Politov, M. E., Panov, N. V. (2017). Acute and chronic pain syndrome after total hip and knee replacement. Anesthesiology and Intensive Care, 63 (3), 224–230.
  14. Pisarev, V. V., L’Vov, S. E., Vasin, I. V., Tikhomolova, E. V. (2012). Regional hemodynamics in different types of surgical treatment of diaphyseal fractures of the shin bone. Traumatology and Orthopedics of Russia, 1, 36–42. doi:
  15. Bohuslavska, N. M., Heorhiiants, M. A. (2015). Choice of method of anesthesiological support of traumatological surgeries in young patients. ScienceRise, 7 (4 (12)), 28–35. doi:
  16. Kalashnykov, O., Stavynskyi, Y., Vdovichenko, K., Kalashnykov, A. (2019). Efficiency of multimodal anаlgesia in orthopedics and traumatology. Pain Medicine, 4 (3), 57–62. doi:
  17. Khvysiuk, O. M., Fesenko, V. S., Zavelia, M. I., Khvysiuk, O. M. (2006). Anesthesia in orthopedics and traumatology. Kharkiv, 416.
  18. Voysekhovskiy, D. V., Averyanov, D. A., Schegolev, A. V., Svistov, D. V. (2018). Effect of deep anesthesia on development of post-operative cognitive dysfunction. Messenger of Anesthesiology and Resuscitation, 15 (1), 5–9. doi:
  19. Bouman, E. A. (2015). Risks and benefits of regional anesthesia in the perioperative setting. Universitaire Pers Maastricht, 124.
  20. Matot, I. (2018). Anesthetics and Trauma: A Complex Interaction. Anesthesia and analgesia, 127 (5), e84–e85. doi:
  21. Kwak, K.-H. (2017). Postdural puncture headache. Korean Journal of Anesthesiology, 70 (2), 136–143. doi:
  22. Yüksek, A., Miniksar, Ö. H., Honca, M., Öz, H. (2020). Incidence and Causes of Failed Spinal Anesthesia. Dubai Medical Journal, 3 (2), 50–54. doi:
  23. Bomberg, H., Wetjen, L., Wagenpfeil, S., Schöpe, J., Kessler, P., Wulf, H. et. al. (2018). Risks and Benefits of Ultrasound, Nerve Stimulation, and Their Combination for Guiding Peripheral Nerve Blocks: A Retrospective Registry Analysis. Anesthesia and analgesia, 127 (4), 1035–1043. doi:
  24. Rowley, P., Boncyk, C., Gaskell, A., Absalom, A., Bonhomme, V., Coburn, M. et. al. (2017). What do people expect of general anaesthesia? British Journal of Anaesthesia, 118 (4), 486–488. doi:
  25. Musaeva, T. S., Dashevsky, S. P., Trembach, N. V. (2017). Comparative analysis of combined anesthesia course based on sevoflurane or propofol in old age patients with different levels of wakefulness. Russian journal of anaesthesiology and reanimatology, 62 (5), 363–368.
  26. Sikorski, R. A., Koerner, A. K., Fouche-Weber, L. Y., Galvagno, S. M. (2014). Choice of General Anesthetics for Trauma Patients. Current Anesthesiology Reports, 4 (3), 225–232. doi:
  27. Hlumcher, F. S. (2013). Induction and maintenance of inhalation anesthesia (VIMA) with sevoflurane in adult patients requiring surgical placement: assessment of the quality of anesthesia by anesthesiologists and patients. Pain, analgesia and intensive care, 4, 12–26.
  28. Guimarães, J. F., Angonese, C. F., Gomes, R. K., Junior, V. M., Farias, C. (2017). Anesthesia for lower extremity vascular bypass with peripheral nerve block. Revista brasileira de anestesiologia, 67 (6), 626–631. doi:
  29. Lewis, S. R., Price, A., Walker, K. J., McGrattan, K., Smith, A. F. (2015). Ultrasound guidance for upper and lower limb blocks. The Cochrane database of systematic reviews, 2015 (9), CD006459. doi:
  30. Guay, J., Suresh, S., Kopp, S. (2019). The use of ultrasound guidance for perioperative neuraxial and peripheral nerve blocks in children. The Cochrane database of systematic reviews, 2 (2), CD011436. doi:
  31. Lončarić-Katušin, M., Mišković, P., Lavrnja-Skolan, V., Katušin, J., Bakota, B., Žunić, J. (2017). General versus spinal anaesthesia in proximal femoral fracture surgery – treatment outcomes. Injury, 48, S51–S55. doi:
  32. Kuchyn, Yu. L., Pylypenko, M. M., Nalapko, Yu. I., Krehh, R. (2016). Local anesthetics: a modern view. Pain Medicine, 3, 17–18.
  33. Kim, D. D., Asif, A., Kataria, S. (2016). Presentation of Neurolytic Effect of 10 % Lidocaine after Perineural Ultrasound Guided Injection of a Canine Sciatic Nerve: A Pilot Study. The Korean journal of pain, 29 (3), 158–163. doi:
  34. Nociti, J. R. (2017). Ropivacaine: the newest anesthetic agent celebrates 20 years. Revista Dor, 18 (4). doi:
  35. Singh, R., Maheshwari, V., Rasheed, M., Choubey, S., Sarkar, A. (2016). Comparison of ropivacaine with levobupivacaine under epidural anesthesia in the lower limb orthopedic surgeries: A randomized study. Anesthesia: Essays and Researches, 10 (3), 624–630. doi:
  36. Andreae, M. H., Atchabahian, A., McCrillis, A. M., Chao, J. Y., Suzuki, S., Shinnar, S., Hall, C. B., Lipton, R. B. (2016). Regional versus general anaesthesia for improved cognitive function after procedures other than cardiac surgery or neurosurgery in adult and paediatric patients. The Cochrane database of systematic reviews, 2016 (6), CD008737. doi:
  37. Berger, M., Schenning, K. J., Brown, C. H., Deiner, S. G., Whittington, R. A., Eckenhoff, R. G. (2018). Best Practices for Postoperative Brain Health: Recommendations From the Fifth International Perioperative Neurotoxicity Working Group. Anesthesia and analgesia, 127 (6), 1406–1413. doi:




How to Cite

Georgiyants, M., Popsuishapka, O., Ryndenko, V., Kursov, S., Babalian, V., & Bohuslavska, N. (2021). The problem of choosing anesthesia method for surgical interventions on the lower limbs in young patients. ScienceRise: Medical Science, (2(41), 43–47.



Medical Science