scholarly journals The Role of Peripheral Nerve Blocks in the Interdisciplinary Care of Children with Chronic Pain: A Case Series and Review of the Literature

10.5772/29107 ◽  
2012 ◽  
Author(s):  
Gillian R. ◽  
Nicholas West
Keyword(s):  
Chronic Pain ◽  
Peripheral Nerve ◽  
Case Series ◽  
Interdisciplinary Care ◽  
Review Of The Literature ◽  
Nerve Blocks ◽  
Peripheral Nerve Blocks

scholarly journals Adjuvant Drugs for Peripheral Nerve Blocks: The Role of NMDA Antagonists, Neostigmine, Epinephrine, and Sodium Bicarbonate

2021 ◽  
Vol 11 (3) ◽  
Author(s):  
Amber N. Edinoff ◽  
Joseph S. Fitz-Gerald ◽  
Krisha Andrea A. Holland ◽  
Johnnie G. Reed ◽  
Sarah E. Murnane ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Peripheral Nerve ◽  
Sodium Bicarbonate ◽  
Local Anesthetic ◽  
Synergistic Effects ◽  
Small Sample ◽  
Nerve Blocks ◽  
Duration Of Action ◽  
Peripheral Nerve Blocks

: The potential for misuse, overdose, and chronic use has led researchers to look for other methods to decrease opioid consumption in patients with acute and chronic pain states. The use of peripheral nerve blocks for surgery has gained increasing popularity as it minimizes peripheral pain signals from the nociceptors of local tissue sustaining trauma and inflammation from surgery. The individualization of peripheral nerve blocks using adjuvant drugs has the potential to improve patient outcomes and reduce chronic pain. The major limitations of peripheral nerve blocks are their limited duration of action and dose-dependent adverse effects. Adjuvant drugs for peripheral nerve blocks show increasing potential as a solution for postoperative and chronic pain with their synergistic effects to increase the duration of action and decrease the required dosage of local anesthetic. N-methyl-d-aspartate (NMDA) receptor antagonists are a viable option for patients with opioid resistance and neuropathic pain due to their affinity to the neurotransmitter glutamate, which is released when patients experience a noxious stimulus. Neostigmine is a cholinesterase inhibitor that exerts its effect by competitively binding at the active site of acetylcholinesterase, which prevents the hydrolysis of acetylcholine and subsequently retaining acetylcholine at the nerve terminal. Epinephrine, also known as adrenaline, can potentially be used as an adjuvant to accelerate and prolong analgesic effects in digital nerve blocks. The theorized role of sodium bicarbonate in local anesthetic preparations is to increase the pH of the anesthetic. The resulting alkaline solution enables the anesthetic to more readily exist in its un-ionized form, which more efficiently crosses lipid membranes of peripheral nerves. However, more research is needed to show the efficacy of these adjuvants for nerve block prolongation as studies have been either mixed or have small sample sizes.

scholarly journals Ultrasound Guidance for Deep Peripheral Nerve Blocks: A Brief Review

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Anupama Wadhwa ◽  
Sunitha Kanchi Kandadai ◽  
Sujittra Tongpresert ◽  
Detlef Obal ◽  
Ralf Erich Gebhard
Keyword(s):  
Peripheral Nerve ◽  
Regional Anesthesia ◽  
Nerve Stimulation ◽  
Nerve Blocks ◽  
Peripheral Nerve Blocks ◽  
Sense Of Security ◽  
False Sense ◽  
Anesthesia Technique ◽  
Additional Value

Nerve stimulation and ultrasound have been introduced to the practice of regional anesthesia mostly in the last two decades. Ultrasound did not gain as much popularity as the nerve stimulation until a decade ago because of the simplicity, accuracy and portability of the nerve stimulator. Ultrasound is now available in most academic centers practicing regional anesthesia and is a popular tool amongst trainees for performance of nerve blocks. This review article specifically discusses the role of ultrasonography for deeply situated nerves or plexuses such as the infraclavicular block for the upper extremity and lumbar plexus and sciatic nerve blocks for the lower extremity. Transitioning from nerve stimulation to ultrasound-guided blocks alone or in combination is beneficial in certain scenarios. However, not every patient undergoing regional anesthesia technique benefits from the use of ultrasound, especially when circumstances resulting in difficult visualization such as deep nerve blocks and/or block performed by inexperienced ultrasonographers. The use of ultrasound does not replace experience and knowledge of relevant anatomy, especially for visualization of deep structures. In certain scenarios, ultrasound may not offer additional value and substantial amount of time may be spent trying to find relevant structures or even provide a false sense of security, especially to an inexperienced operator. We look at available literature on the role of ultrasound for the performance of deep peripheral nerve blocks and its benefits.

scholarly journals Ultrasound-guided peripheral nerve blocks in anticoagulated patients – case series

2017 ◽  
Vol 67 (1) ◽  
pp. 100-106
Author(s):  
Luis Eduardo Silveira Martins ◽  
Leonardo Henrique Cunha Ferraro ◽  
Alexandre Takeda ◽  
Masashi Munechika ◽  
Maria Angela Tardelli
Keyword(s):  
Peripheral Nerve ◽  
Case Series ◽  
Ultrasound Guided ◽  
Nerve Blocks ◽  
Peripheral Nerve Blocks ◽  
Anticoagulated Patients

A case series of peripheral nerve blocks in pediatrics and young adults with skeletal dysplasia

2016 ◽  
Vol 26 (5) ◽  
pp. 553-556 ◽  
Author(s):  
James R. Eiszner ◽  
Alfred Atanda ◽  
Ashwin Rangavajjula ◽  
Mary Theroux
Keyword(s):  
Young Adults ◽  
Peripheral Nerve ◽  
Skeletal Dysplasia ◽  
Case Series ◽  
Nerve Blocks ◽  
Peripheral Nerve Blocks
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