Lower extremity blocks for analgesia - 01/09/11

Doi : 10.1053/trap.2002.122930

M Yufa, MD, PhD, P Kurc, MD, JD Vloka, MD, PhD, A Hadžić, MD, PhD ⁎
St. Luke's-Roosevelt Hospital Medical Center, College of Physicians and Surgeons Columbia University, New-York, NY

¹Address reprint requests to Admir Hadžić, MD, PhD, Department of Anesthesiology, St. Luke's-Roosevelt Hospital Center, 1111 Amsterdam Avenue, New York, NY 10025

1084-208X/02/0602-0004$35.00/0

Abstract

A large proportion of patients undergoing surgery do not receive adequate postoperative analgesia.^{1Rawal N 10 years of acute pain services-Achievements and challenges Reg Anesth Pain Med 1999 ; 24 : 68-73 [cross-ref]

Cliquez ici pour aller à la section Références} Postoperative pain is the leading cause of unplanned hospital admissions after ambulatory surgery and a major source of dissatisfaction with perioperative outcome.^{2Gold BS, Kitz DS, Lecky JH, et al. Unanticipated admission to the hospital following ambulatory surgery JAMA 1989 ; 262 : 3008-3010

Cliquez ici pour aller à la section Références} The establishment of acute pain services in major institutions both in the United States and overseas has had a major effect on postoperative comfort and patient satisfaction.^{3Maier C, Kibbel K, Mercker S, et al. Postoperative pain therapy at general nursing stations. An analysis of eight years experience at an anesthesiological acute pain service Anaesthetist 1994 ; 43 : 385-397 [cross-ref]

Cliquez ici pour aller à la section Références, 4Ready LB How many acute pain services are there in the US and who is managing patient-controlled analgesia? Anesthesiology 1995 ; 82 : 322(letter).

Cliquez ici pour aller à la section Références} Most acute pain services primarily use intravenous patient-controlled analgesia (PCA) or patient-controlled epidural infusion; however, advances in neuronal blockade offer an unprecedented range of effective and surgery site–specific analgesic options. Using long-acting local anesthetics, peripheral nerve blocks can be used to provide an excellent anesthesia and postoperative analgesia. Additionally, a catheter for continuous infusion of local anesthetics can be inserted perineurally to extend the analgesia beyond the duration of the single-shot blocks. This review will discuss the advantages and limitations of various nerve block techniques when used for postoperative pain management for several common surgical indications. Copyright 2002, Elsevier Science (USA). All rights reserved.