Continuous peripheral nerve blocks in the ambulatory setting

Abstract

Recent advancements in equipment for cPNB facilitate the usage in the ambulatory setting. Research-supported ambulatory cPNB indications have expanded to include pediatric subpopulations and major breast surgery, while further evidence mounts for its efficacy in patient populations with previously demonstrated benefits, such as foot, ankle and shoulder surgery.

Should continuous rather than single-injection interscalene block be routinely offered for major shoulder surgery? A meta-analysis of the analgesic and side-effects profiles

“…The lack of difference in the time-to-first analgesic request between the two groups was noteworthy; but that can be attributed to breakthrough pain when the surgical block (initial bolus) wears off in the CISB group. 71,72 The observed comparative efficacy of CISB, together with accumulating evidence of its benefits, 73 and recent evidence supporting its safety and practicality, 9 help in closing the evidence gap in the use of CISB in this surgical population. Indeed, the lack of clarity of benefits has contributed to the heterogeneity of practice.…”

Guidelines for day‐case surgery 2019

“…The expected duration of the blockade should be explained and the patient should receive written instructions as to their conduct until normal power and sensation return. Infusions of local anaesthetics may also have a role . The use of ultrasound guidance continues to expand the role of regional anaesthesia in day surgery, enabling more accurate local anaesthetic placement, reducing the total dose administered and supporting the development of regional anaesthetic operating lists.…”

Adverse events associated with continuous interscalene block administered using the catheter-over-needle method: a retrospective analysis

“…Continuous interscalene block, incorporating the basal infusion of a local anesthetic and patient-controlled boluses, is one of the most effective and frequently used analgesic techniques after both major and minor shoulder surgeries [1][2][3][4]. Many authors have supported the efficacy and safety of continuous interscalene block in ambulatory patients [5][6][7][8][9]. These reports have focused on the adverse events associated with continuous interscalene block performed using the catheterthrough-needle method [10,11].…”