Abstract

DOMINGO, V.; AGUILAR, J. L.  and  PELAEZ, R.. Lower limb continuous peripheral nerve blocks for postoperative analgesia and chronic pain. Rev. Soc. Esp. Dolor [online]. 2004, vol.11, n.4, pp.61-75. ISSN 1134-8046.

There is increasing interest in peripheral nerve blocks (PNB) because of potential benefits relative to interactions of anticoagulants and central neuraxial techniques. Among all the regional anesthesia procedures, PNB of the lower limb, and specially sciatic nerve block, are the less known and rarely used. In this paper, we summarize the recent advances in lumbosacral plexus block, with special remark on continuous catheter blocks for postoperative analgesia and chronic pain treatment. The use of long action local anes-thetics combined with a weak motor block, like ropivacaine, permits the combination of a single skin injection technique to achieve an adequate intraoperative analgesia with continuous infusion ones for postoperative analgesia. A detailed knowledge of anatomy as well as cutaneous nerve distribution is needed for the performance of these techniques. The introduction of several image-based techniques, principally ultrasound imaging, may improve the accuracy of nerve localization and needle placement. It also can help to prevent accidental puncture to vessels and other neighbouring structures. Continuous plexus and peripheral nerve blocks offer the potential benefits of prolonged analgesia with fewer side effects, greater patient satisfaction, and faster functional recovery after surgery.

Keywords : Peripheral nerve blocks; Sciatic nerve block; Femoral nerve block; Lumbar plexus block; Continuous postoperative analgesia.

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