Continuous peripheral nerve blocks

State of the art

Paolo Grossi, Massimo Allegri

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Purpose of review: This review was performed through a Medline research to evaluate articles published between January 2004 and April 2005. Technical procedures, indications, drugs, infusion regimens, and complications of continuous peripheral nerve blocks were considered. Recent findings: A total of 27 articles were reviewed. With respect to technical procedures, the authors focused on advantages of stimulating catheters or ultrasound guidance. With the help of these techniques, a correct catheter placement as close to the targeted nerve as possible was obtained. The total amount of local anesthetic administered was thereby reduced. Using ultrasound needle guidance, the spread of local anesthetic around the nerve could be visualized. Articles dealing with the choice of local anesthetic showed equianalgesia and equipotency of continuous perineural infusion of levobupivacaine 0.125% and ropivacaine 0.2%. The best infusion regimen for postoperative analgesia appears to be a combination of a preset basal rate administered together with small bolus doses in almost all continuous peripheral nerve blocks. Overall, complications such as infections, local anesthetic toxic plasma levels, hematoma formation, or nerve injury seem to be rare in continuous peripheral nerve blockade. Summary: Continuous peripheral nerve blockade is an effective and safe technique for postoperative analgesia, even when administered at home. To optimize this technique, further studies are needed to help minimize the risk of side effects, improve techniques to locate the targeted nerve (stimulating catheters or ultrasound imaging) and choose less toxic drugs (levobupivacaine and ropivacaine) with more effective infusion regimens.

Original languageEnglish
Pages (from-to)522-526
Number of pages5
JournalCurrent Opinion in Anaesthesiology
Volume18
Issue number5
Publication statusPublished - Oct 2005

Fingerprint

Nerve Block
Local Anesthetics
Peripheral Nerves
Catheters
Poisons
Analgesia
Hematoma
Pharmaceutical Preparations
Needles
Ultrasonography
Wounds and Injuries
Infection
Research
levobupivacaine
ropivacaine

Keywords

  • Continuous nerve block
  • Peripheral nerve block
  • Ultrasound guidance nerve block

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Continuous peripheral nerve blocks : State of the art. / Grossi, Paolo; Allegri, Massimo.

In: Current Opinion in Anaesthesiology, Vol. 18, No. 5, 10.2005, p. 522-526.

Research output: Contribution to journalArticle

Grossi, P & Allegri, M 2005, 'Continuous peripheral nerve blocks: State of the art', Current Opinion in Anaesthesiology, vol. 18, no. 5, pp. 522-526.
Grossi, Paolo ; Allegri, Massimo. / Continuous peripheral nerve blocks : State of the art. In: Current Opinion in Anaesthesiology. 2005 ; Vol. 18, No. 5. pp. 522-526.
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