scholarly journals Pain Management Strategies Postoperatively in Arthroscopy of Foot & Ankle: A Review Article

2021 ◽  
Vol 2 (3) ◽  
pp. 097-099
Author(s):  
C LaPorte ◽  
MD Rahl ◽  
OR Ayeni ◽  
TJ Menge
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Peripheral Nerve ◽  
Management Strategies ◽  
Therapeutic Benefit ◽  
Opioid Use ◽  
Nerve Blocks ◽  
Analgesic Regimen ◽  
Post Operative Pain ◽  
Modal Treatment

Foot & Ankle arthroscopy is an increasingly rapid field in the treatment of multiple hip conditions, owing to its important diagnostic and therapeutic benefit. As these patients lack a consistent pain relief plan, effective post-operative pain control appears to be a concern. Several methods were used to identify a method that decreases post-operative pain, narcotic intake and hospital and treatment system costs. This article aims to study and report the relevant findings of the previous paper “Post-operative pain management strategies in hip arthroscopy.” Latest research encourages the use of a multimodal approach to the treatment of postoperative pain in hip arthroscopic patients. In tandem with peripheral nerve blocks or intraoperative anesthetic injection a pre- and after-operative analgesic regimen is used, patients experience lower discomfort and post-operative narcotic use. Different methods are similar in post-operative pain and opioid use. However, of those undergoing Intraarticular (IA) or Local Anesthetic Infiltration (LAI), postoperative risks relative to peripheral nervous blocks are smaller. Latest trials have demonstrated that the best and most reliable, multi-modal treatment for the reduction of postoperative pain in these patients may be intraoperative techniques such as IA injection or LAI in combination with a pre and postoperative analgesy. Furthermore, failure to use the peripheral nerve block can result in lower anesthesia procedural fees and operating room turnover, thereby lowering patients’ costs and increasing facility effectiveness.

The Effects of Perioperative Peripheral Nerve Blocks on Peri- and Postoperative Opioid Use and Pain Management

2021 ◽  
pp. 000313482110233
Author(s):  
Taylor W. Cardwell ◽  
Vanessa Zabala ◽  
Jocelyn Mineo ◽  
Christopher N. Ochner
Keyword(s):  
Pain Management ◽  
Peripheral Nerve ◽  
Nerve Block ◽  
Opioid Consumption ◽  
Opioid Use ◽  
Nerve Blocks ◽  
Peripheral Nerve Blocks ◽  
Pain Scores ◽  
Patient Reported ◽  
Postoperative Physical Therapy

Introduction The amount of peri- and post-operative use of opioids for pain management, and the duration in which they are used following surgery, are positively associated with the likelihood of subsequent opioid use and addiction. Aware of this issue, many clinicians are seeking ways to reduce opioid use while maintaining adequate pain management. Recent evidence suggests that peripheral nerve block utilization may present a viable mechanism by which clinicians can accomplish this goal. Methods Ovid MEDLINE and Pubmed databases were searched to identify relevant articles. Using the advanced search option, the key terms “opioid,” “morphine,” “nerve block,” “peripheral anesthesia,” “pain management,” “preoperative,”, “intraoperative,” and “postoperative” were used and combined with the Boolean terms “AND” and “OR.” This review examines the extant literature surrounding the use of peripheral nerve blocks in relation to patient-reported pain scores, intraoperative opioids, postoperative opioids, patient-controlled analgesic with opioids, and opioid consumption once the patient has left the hospital. Further, the effect peripheral nerve blocks have on postoperative physical therapy, surgery related complications, and overall patient satisfaction are briefly discussed. Results The use of perioperative peripheral nerve blocks decreases opioid consumption not only in the postoperative period, but also intraoperatively as well. The most significant decrease in opioid consumption is seen in the first 24-72 hours postoperatively. Patient reported pain scores were also lower in patients who received peripheral nerve blocks. Discussion Despite relatively robust efficacy data, utilization of peripheral nerve blocks is not ubiquitous; the potential reasons for which are also discussed. Lastly, clinical recommendations based on the available data are provided.

scholarly journals Evidence-based Review of Periarticular Injections and Peripheral Nerve Blocks in Total Knee Arthroplasty

2020 ◽  
Vol 14 (1) ◽  
pp. 69-72
Author(s):  
Alexander Gaukhman ◽  
Simon Garceau ◽  
Ran Schwarzkopf ◽  
James Slover
Keyword(s):  
Total Knee Arthroplasty ◽  
Pain Management ◽  
Peripheral Nerve ◽  
Regional Anesthesia ◽  
Knee Arthroplasty ◽  
Motor Blockade ◽  
Nerve Blocks ◽  
Peripheral Nerve Blocks ◽  
Post Operative Pain ◽  
Total Knee

Background: Recently, post-operative pain management after Total Knee Arthroplasty (TKA) has focused on a multimodal approach for reducing opioid requirements, promoting early rehabilitation, and expediting discharge from hospital. Regional anesthesia, in the form of Periarticular Injections (PAI) and Peripheral Nerve Blocks (PNB), has shown promise as adjunctive therapy to oral analgesics. Objective: To review the current literature surrounding regional anesthesia for TKA. Discussion: PNBs provide effective analgesia after TKA. Historically, femoral nerve blocks (FNB) have been commonly employed. FNBs, however, lead to the significant motor blockade to the quadriceps musculature, which can dampen early rehabilitation efforts and increase the risk of post-operative falls. Adductor Canal Blocks (ACB) have shown excellent results in reducing post-operative pain while minimizing motor blockade. Periarticular injections (PAI), and infiltration between the popliteal Artery and Capsule of the Knee (IPACK) have similarly helped in reducing patient discomfort after TKA and providing analgesia to the posterior capsular region of the knee. Conclusion: PAIs, and PNBs are important elements in many multimodal postoperative pain management protocols after TKA. Current evidence appears to suggest that a combination of an ACB supplemented by posterior capsular analgesic coverage through PAI or IPACK may provide optimal results.

Acute pain management in trauma: anatomy, ultrasound-guided peripheral nerve blocks and special considerations

2019 ◽  
Vol 85 (7) ◽  
Author(s):  
Theodosios Saranteas ◽  
Iosifina Koliantzaki ◽  
Olga Savvidou ◽  
Marina Tsoumpa ◽  
Georgia Eustathiou ◽  
...  
Keyword(s):  
Pain Management ◽  
Peripheral Nerve ◽  
Acute Pain ◽  
Ultrasound Guided ◽  
Acute Pain Management ◽  
Nerve Blocks ◽  
Peripheral Nerve Blocks
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