Continuous peripheral nerve blocks in the hospital and at home

Abstract

A single-injection peripheral nerve block using long-acting local anesthetic provides analgesia for 12 to 24 hours; however, many surgical procedures result in pain that lasts far longer. One relatively new option is a continuous peripheral nerve block (CPNB): local anesthetic is perfused via a perineural catheter directly adjacent to the peripheral nerve(s) supplying the surgical site, providing potent, site-specific analgesia. CPNB results in decreased pain, opioid requirements, opioid-related side effects, and sleep disturbances; in some cases, accelerating resumption of tolerated passive joint range-of-motion and increasing patient satisfaction. Ambulatory perineural infusion may be provided using a portable infusion pump, in some cases resulting in decreased hospitalization duration and related costs. Serious complications are rare, but may result in significant morbidity.