• Best Pract Res Clin Anaesthesiol · Sep 2019

    Review

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

    • Rodney A Gabriel and Brian M Ilfeld.
    • Department of Anesthesiology, University of California, 200 West Arbor Dr, MC 8770, San Diego, CA 92103, USA. Electronic address: ragabriel@ucsd.edu.
    • Best Pract Res Clin Anaesthesiol. 2019 Sep 1; 33 (3): 293-302.

    AbstractPeripheral 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.Copyright © 2019. Published by Elsevier Ltd.

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