Regional anesthesia and pain medicine
-
Reg Anesth Pain Med · Sep 2016
Peripheral Nerve Block Facilitates Acute Inflammatory Responses Induced by Surgical Incision in Mice.
Anesthesia with peripheral nerve block (PNB) improves the early recovery profile of patients undergoing surgery, including the control of postoperative pain, opioid consumption, and the length of hospital stay. However, the influence of PNB on wound inflammation and the repair process has not been fully investigated. Therefore, we evaluated the effects of PNB on local inflammation of incised tissue in the acute phase of postoperative pain development. ⋯ Single PNB before incision promoted acute phase inflammation mediated by neutrophils and macrophages at the sites of incision, whereas postoperative pain was not altered. Peripheral nerve block might locally accelerate innate immune responses after surgical incision without altering the nociceptive profile.
-
Reg Anesth Pain Med · Sep 2016
Comparative StudyRelative Contribution of Adjuvants to Local Anesthetic for Prolonging the Duration of Peripheral Nerve Blocks in Rats.
A chemically compatible, safe 4-drug multimodal formulation of bupivacaine combined with 3 adjuvants (clonidine, buprenorphine, and dexamethasone) has been proposed for long-lasting single-injection peripheral nerve blocks in patients. However, the relative importance of each of the adjuvants of the 4-drug formulation in producing long-lasting nerve blocks has not been determined. The aim of this study in rats was to determine which adjuvants (clonidine, buprenorphine, or dexamethasone) are essential for producing a long-lasting nerve block. ⋯ This animal study confirmed that the 4-drug multimodal formulation proposed for clinical nerve block produces superior duration of action compared to local anesthetic alone. This rat sciatic nerve model also indicated that one of the 3 adjuvants, clonidine, could by itself account for the extended duration of nerve block of bupivacaine.