Upper extremity nerve block : How can benefit, duration, and safety be improved? An update [version 1; referees: 3 approved]
(2016) In F1000Research 5.- Abstract
Upper extremity blocks are useful as both sole anaesthesia and/or a supplement to general anaesthesia and they further provide effective postoperative analgesia, reducing the need for opioid analgesics. There is without doubt a renewed interest among anaesthesiologists in the interscalene, supraclavicular, infraclavicular, and axillary plexus blocks with the increasing use of ultrasound guidance. The ultrasound-guided technique visualising the needle tip and solution injected reduces the risk of side effects, accidental intravascular injection, and possibly also trauma to surrounding tissues. The ultrasound technique has also reduced the volume needed in order to gain effective block. Still, single-shot plexus block, although it... (More)
Upper extremity blocks are useful as both sole anaesthesia and/or a supplement to general anaesthesia and they further provide effective postoperative analgesia, reducing the need for opioid analgesics. There is without doubt a renewed interest among anaesthesiologists in the interscalene, supraclavicular, infraclavicular, and axillary plexus blocks with the increasing use of ultrasound guidance. The ultrasound-guided technique visualising the needle tip and solution injected reduces the risk of side effects, accidental intravascular injection, and possibly also trauma to surrounding tissues. The ultrasound technique has also reduced the volume needed in order to gain effective block. Still, single-shot plexus block, although it produces effective anaesthesia, has a limited duration of postoperative analgesia and a number of adjuncts have been tested in order to prolong analgesia duration. The addition of steroids, midazolam, clonidine, dexmedetomidine, and buprenorphine has been studied, all being off-label when administered by perineural injection, and the potential neurotoxicity needs further study. The use of perineural catheters is an effective option to improve and prolong the postoperative analgesic effect. Upper extremity plexus blocks have an obvious place as a sole anaesthetic technique or as a powerful complement to general anaesthesia, reducing the need for analgesics and hypnotics intraoperatively, and provide effective early postoperative pain relief. Continuous perineural infusion is an effective option to prolong the effects and improve postoperative quality.
(Less)
- author
- Brattwall, Metha ; Jildenstål, Pether LU ; Stomberg, Margareta Warrén and Jakobsson, Jan G.
- publishing date
- 2016-01-01
- type
- Contribution to journal
- publication status
- published
- subject
- in
- F1000Research
- volume
- 5
- article number
- 907
- publisher
- F1000 Research Ltd.
- external identifiers
-
- scopus:85010866750
- ISSN
- 2046-1402
- DOI
- 10.12688/F1000RESEARCH.7292.1
- language
- English
- LU publication?
- no
- id
- 46ef3a63-fe63-46d3-9cf9-3e1dd3ed5a73
- date added to LUP
- 2020-09-27 20:57:51
- date last changed
- 2022-03-26 06:46:57
@article{46ef3a63-fe63-46d3-9cf9-3e1dd3ed5a73,
abstract = {{<p>Upper extremity blocks are useful as both sole anaesthesia and/or a supplement to general anaesthesia and they further provide effective postoperative analgesia, reducing the need for opioid analgesics. There is without doubt a renewed interest among anaesthesiologists in the interscalene, supraclavicular, infraclavicular, and axillary plexus blocks with the increasing use of ultrasound guidance. The ultrasound-guided technique visualising the needle tip and solution injected reduces the risk of side effects, accidental intravascular injection, and possibly also trauma to surrounding tissues. The ultrasound technique has also reduced the volume needed in order to gain effective block. Still, single-shot plexus block, although it produces effective anaesthesia, has a limited duration of postoperative analgesia and a number of adjuncts have been tested in order to prolong analgesia duration. The addition of steroids, midazolam, clonidine, dexmedetomidine, and buprenorphine has been studied, all being off-label when administered by perineural injection, and the potential neurotoxicity needs further study. The use of perineural catheters is an effective option to improve and prolong the postoperative analgesic effect. Upper extremity plexus blocks have an obvious place as a sole anaesthetic technique or as a powerful complement to general anaesthesia, reducing the need for analgesics and hypnotics intraoperatively, and provide effective early postoperative pain relief. Continuous perineural infusion is an effective option to prolong the effects and improve postoperative quality.</p>}},
author = {{Brattwall, Metha and Jildenstål, Pether and Stomberg, Margareta Warrén and Jakobsson, Jan G.}},
issn = {{2046-1402}},
language = {{eng}},
month = {{01}},
publisher = {{F1000 Research Ltd.}},
series = {{F1000Research}},
title = {{Upper extremity nerve block : How can benefit, duration, and safety be improved? An update [version 1; referees: 3 approved]}},
url = {{http://dx.doi.org/10.12688/F1000RESEARCH.7292.1}},
doi = {{10.12688/F1000RESEARCH.7292.1}},
volume = {{5}},
year = {{2016}},
}