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Best Pract Res Clin Anaesthesiol. 2019 Mar;33(1):37-46. doi: 10.1016/j.bpa.2019.02.002. Epub 2019 Apr 5.

Percutaneous peripheral nerve stimulation and other alternatives for perineural catheters for postoperative analgesia.

Author information

1
Department of Anesthesiology, University of California, 200 West Arbor Dr, MC 8770, San Diego, CA 92103, USA. Electronic address: ragabriel@ucsd.edu.
2
Department of Anesthesiology, University of California, 200 West Arbor Dr, MC 8770, San Diego, CA 92103, USA. Electronic address: bilfeld@ucsd.edu.

Abstract

A perineural catheter with a continuous infusion of local anesthetic is an excellent option for postoperative analgesia; however, its limitations include limited duration of action (i.e., 3-7 days) as well as a risk of infection and dislodgement. Furthermore, these blocks may cause dense sensory and motor blockades that under certain circumstances may not be ideal. There is novel evidence that ultrasound-guided percutaneous peripheral nerve stimulation (pPNS) may serve as an alternative approach free of the limitations associated with peripheral nerve blocks. In this review, we discuss the evidence for pPNS on postoperative acute pain management. Subsequently, we briefly discuss additional alternatives to continuous peripheral nerve blocks, including cryoanalgesia and liposomal bupivacaine.

KEYWORDS:

acute pain; cryoneurolysis; liposomal bupivacaine; liposome bupivacaine; post-surgical analgesia

PMID:
31272652
DOI:
10.1016/j.bpa.2019.02.002

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