Format

Send to

Choose Destination
Best Pract Res Clin Anaesthesiol. 2019 Sep;33(3):293-302. doi: 10.1016/j.bpa.2019.06.002. Epub 2019 Jul 3.

Peripheral nerve blocks for postoperative analgesia: From traditional unencapsulated local anesthetic to liposomes, cryoneurolysis and peripheral nerve stimulation.

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

Peripheral nerve blocks (PNBs) using local anesthetics either via single injection or continuous perineural catheter have been the mainstay for regional anesthesia and are a vital component of postoperative multimodal opioid-sparing pain management. There are some limitations to PNBs, however, mainly its limited duration of action, but also risk of catheter-associated infection and dislodgements. Furthermore, local anesthetic-based blocks can induce sensory deficits and motor weakness, possibly increasing the risk of falling and/or decreasing the ability to participate in postoperative rehabilitation. In this review, we first discuss various local anesthetic-based PNB techniques for major surgery and then review newer modalities, including liposome bupivacaine, cryoanalgesia, and peripheral nerve stimulation; all of which may offer advantages over single and continuous local anesthetic-based PNBs.

KEYWORDS:

cryoanalgesia; liposome bupivacaine; peripheral nerve blocks; peripheral nerve stimulation; regional anesthesia

PMID:
31785715
DOI:
10.1016/j.bpa.2019.06.002

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center