PERIPHERAL NERVE BLOCKS: AN ALTERNATIVE TO OPIODS IN POST-OPERATIVE PAIN: - A META ANAYSIS STUDY.

Dr. Kanika; Dr. Karan Siwach; Dr. Mayank Dutta; Dr. Aman Siwach

Volume : VII, Issue : XI, November - 2018

PERIPHERAL NERVE BLOCKS: AN ALTERNATIVE TO OPIODS IN POST-OPERATIVE PAIN: - A META ANAYSIS STUDY.

Dr. Kanika, Dr. Karan Siwach, Dr. Mayank Dutta, Dr. Aman Siwach

Abstract :

Peripheral nerve blocks (PNBs) are increasingly used as a method of multimodal analgesia and can be administered as a single injection (sPNB) or continuous infusion via a perineural catheter (cPNB). Meta–analyses of randomized controlled trials have shown superior pain control and reductions in opioid consumption in patients receiving PNB compared with those receiving intravenous opioids in a variety of upper and lower extremity surgical procedures. Risks of PNB, regardless of technique or block location, include vascular puncture and bleeding, nerve damage, and local anesthetic systemic toxicity. Site–specific complications include quadriceps weakness in patients receiving femoral nerve block, and pleural puncture or neuraxial blockade in patients receiving interscalene block. The major limitation of sPNB is the short (12–24 hours) duration of action. cPNB may be complicated by catheter obstruction, migration, and leakage of local anesthetic as well as accidental removal of catheters. The ideal PNB technique would have a duration of action that is sufficiently long to address the most intense period of postsurgical pain; should be associated with minimal risk of infection, neurologic complications, bleeding, and local anesthetic systemic toxicity; and should be easy to perform, convenient for patients, and easy to manage in the postoperative period.