Continuous peripheral nerve blockade for postoperative analgesia

Le-Wendling, Linda; Enneking, F. Kayser

doi:10.1097/aco.0b013e32830a4be6

Cited by 22 publications

(10 citation statements)

References 28 publications

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“…The indication for cPNB has evolved since then, and many indications have been described in the literature: treatment of vasospasm induced by Raynaud disease [4]; induction of sympathectomy and vasodilation for improvement of blood flow after vascular surgery/trauma [5, 6], replantation or limb salvage [7, 8]; treatment of peripheral embolism [9, 10]; analgesia in the setting of trauma [11]; treatment of chronic pain syndrome such as trigeminal neuralgia [12], complex regional pain syndrome [13], terminal cancer pain, [14], and phantom limb pain [15, 16]. Independently of these indications, the majority of publications dealing with cPNB focus on postsurgical pain treatment, where evidence supports the concept that regional anesthesia and analgesia offers superior pain relief to systemic opioid analgesia following major surgery [17]. However, postsurgical pain is the only indication which has been validated using randomized controlled trials (RCTs) [18–22].…”

Section: Introductionmentioning

confidence: 99%

The Role of Continuous Peripheral Nerve Blocks

Aguirre

Moral

Cobo

et al. 2012

Anesthesiology Research and Practice

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A continuous peripheral nerve block (cPNB) is provided in the hospital and ambulatory setting. The most common use of CPNBs is in the peri- and postoperative period but different indications have been described like the treatment of chronic pain such as cancer-induced pain, complex regional pain syndrome or phantom limb pain. The documented benefits strongly depend on the analgesia quality and include decreasing baseline/dynamic pain, reducing additional analgesic requirements, decrease of postoperative joint inflammation and inflammatory markers, sleep disturbances and opioid-related side effects, increase of patient satisfaction and ambulation/functioning improvement, an accelerated resumption of passive joint range-of-motion, reducing time until discharge readiness, decrease in blood loss/blood transfusions, potential reduction of the incidence of postsurgical chronic pain and reduction of costs. Evidence deriving from randomized controlled trials suggests that in some situations there are also prolonged benefits of regional anesthesia after catheter removal in addition to the immediate postoperative effects. Unfortunately, there are only few data demonstrating benefits after catheter removal and the evidence of medium- or long-term improvements in health-related quality of life measures is still lacking. This review will give an overview of the advantages and adverse effects of cPNBs.

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Section: Introductionmentioning

confidence: 99%

The Role of Continuous Peripheral Nerve Blocks

Aguirre

Moral

Cobo

et al. 2012

Anesthesiology Research and Practice

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“…Блокада сідничного нерва на рівні підколінної ямки зазвичай добре переноситься пацієнтами, не порушуючи їх рухової активності [47,54]. Є роботи по застосуванню тривалих катетерних методик блокади сідничного нерва в підколінній ямці заднім доступом з постановкою катетера [7,38].…”

Section: блокада сідничного нерва на рівні підколінної ямкиunclassified

“…Поява моторної відповіді при тривалості імпульсу 0,1 мс і силі струму 0,5 мА вказує на максимально точне розташування кінця голки по відношенню до нерва [45]. Частота успішної анестезії наближається до 95-100 % [46,47]. При силі струму вище 0,5 мА збільшується ризик неповної або невдалої анестезії.…”

Section: методика виконання блокад нервів нижньої кінцівкиunclassified

Mini-invasive methods of treatment of diabetic foot pain

Dmytriiev

Lysak

Glazov³

et al. 2019

PMJUA

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Neuropathic pain occurs with diabetic polyneuropathy more often than with all polyneuropathies of another etiology. Because the cause of pain can rarely be cured, treatment is usually symptomatic. Neuropathic pain is usually poorly controlled by analgesics. Management of neuropathic pain is started with conservative pharmacotherapy before invasive pain management is applied. Although there are many drugs that can be used in patients with diabetic pain syndrome, pain syndrome can not be surely stoped with monotherapy. In addition, the patient may not tolerate the full therapeutic dose of the drug. All this dictates the need for combination therapy. It is believed that regional anesthesia as an independent type of analgesia or a component of combined anesthesia is the method of choice for the elderly and senile patients. The main reasons for this choice, when comparing regional anesthesia with narcosis, are less stressful response of the organism, absence of depression of the central nervous system, stable reliable analgesia with complete blockade of nociceptive reflexes with the provision of adequate muscle relaxation, prevention of neurovegetative reactions, which ultimately helps to reduce the incidence of postoperative complications and mortality. Clinicians have accumulated considerable experience demonstrating the need for regional analgesia in the management of diabetic foot pain.

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“…Common complications of peripheral nerve block include failed or partial block (requiring supplementation), vascular puncture and transient neuropathy (3:100). 9 Other potential complications include catheter kinking and dislodgement (up to 5.5% risk), leaking at the catheter insertion site (<10%), pump failure and disconnection. Very few cases of LA toxicity have been reported in cases of CPNB, most likely because low concentrations are used and the infusion rate rarely exceeds 10 ml/hour.…”

Section: Safety and Complicationsmentioning

confidence: 99%

Peripheral regional techniques for acute pain treatment

Snaith¹,

Dolan²

2011

Anaesthesia & Intensive Care Medicine

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Regional anaesthesia has many advantages over systemic analgesia alone for postoperative pain and rehabilitation. Advances in continuous peripheral nerve block techniques enable the benefits of single injection blockade to be extended, providing prolonged, site-specific analgesia. A wide range of equipment, local anaesthetic solutions and adjuvants can be used to provide peripheral nerve blockade. In this article we review equipment, drugs, techniques, indications, benefits and potential complications of peripheral nerve blockade, focussing on continuous perineural catheter techniques.

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Continuous peripheral nerve blockade for postoperative analgesia

Abstract: Continuous peripheral nerve blocks are an excellent additional modality to compliment other multimodal analgesics to control moderate to severe postoperative pain.

Cited by 22 publications

References 28 publications

The Role of Continuous Peripheral Nerve Blocks

The Role of Continuous Peripheral Nerve Blocks

Mini-invasive methods of treatment of diabetic foot pain

Peripheral regional techniques for acute pain treatment

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