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Peripheral Nerve Blocks

Peripheral Nerve Blocks - Clinical Hub, References, Pain Management Resources, Anesthesia Acute Pain Service


Single Shot Blocks

A single‐shot nerve block is the injection of local anesthetic to block a specific nerve distribution. It can be placed pre‐ or post‐operatively to provide anesthesia and/or analgesia. The area affected will vary based on where the local anesthetic is injected. The onset and duration will vary based on the type of block, as well as the type of local anesthetic used. In addition, catheters with a continuousinfusion may be placed to prolong analgesia.

Continuous Peripheral Nerve Blockade

Continuous peripheral nerve blockade, also called “perineural local anesthetic infusion” involves the percutaneous insertion of a catheter directly adjacent to the peripheral nerve(s) supplying a surgical site or discrete painful area. Local anesthetic is then infused through the catheter to bathe the nerve providing site-specific pain control. Catheters can be placed by an anesthesiologist in various anatomic locations including paravertebral, interscalene, infraclavicular, axillary, lumbar plexus, femoral fascia iliac, sciatic at the level of the hip or knee and tibial nerve placement.

Indications: Patients who have moderate to severe post-operative pain that cannot be easily managed with opioids and other analgesics. Systematic review and meta-analysis have associated continuous peripheral nerve blocks with improved pain control, decreased need for opioid analgesics, less nausea and improved patient satisfaction.

Contraindications: Anticoagulation, infection, local anesthetic allergy, hepatic or renal insufficiency.

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