Percutaneous Peripheral Nerve Stimulation and Other Alternatives for Perineural Catheters for Postoperative Analgesia

Publication date: Available online 5 April 2019Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): Rodney A. Gabriel, Brian M. IlfeldAbstractA perineural catheter with a continuous infusion of local anesthetic is an excellent option for postoperative analgesia; however, its limitations include limited duration of action (i.e. 3 – 7 days) as well as a risk of infection and dislodgement. Furthermore, these blocks may cause dense sensory and motor blockade that under certain circumstances may not be ideal. There is novel evidence that ultrasound-guided percutaneous peripheral nerve stimulation (pPNS) may serve as an alternative approach free of the limitations associated with peripheral nerve blocks. In this review, we discuss the evidence for pPNS on postoperative acute pain management. Subsequently, we briefly discuss additional alternatives to continuous peripheral nerve blocks, including cryoanalgesia and liposomal bupivacaine.
Source: Best Practice and Research Clinical Anaesthesiology - Category: Anesthesiology Source Type: research