[Peripheral nerve blocks and spasticity. Why and how should we use regional blocks?].
Muscle spasticity causes pain, disability, and difficulties in the rehabilitation of patients with cerebrovascular lesions, head, brain or spine trauma, coma, or neurologic diseases such as multiple sclerosis, amyotrophic lateral sclerosis, or cerebral palsy. Regional blocks have a threefold use in patients with painful spasticity: diagnostic, prognostic, and therapeutic. Blocks are feasible on an outpatient or day-hospital basis. Blocks are applied most often to 4 peripheral sites: the pectoral nerve loop, median, obturator, and tibial nerves. The main indication is debilitating or painful spasticity. Peripheral blocks with local anesthetics are used as tests, to mimic the effects of motor blocks and determine their potential adverse effects, transiently and reversibly. Peripheral neurolytic blocks are easy to perform, effective, and inexpensive.
Viel
Eric
E
Centre d'évaluation et de traitement de la douleur, pôle anesthésie-réanimations-douleur-urgences, groupe hospitalo-universitaire Caremeau, faculté de médecine de Montpellier-Nîmes, 30029 Nîmes Cedex 9, France. eric.viel@chu-nimes.fr
Pellas
Frédéric
F
Ripart
Jacques
J
Pélissier
Jacques
J
Eledjam
Jean-Jacques
JJ
D006801:Humans; D009128:Muscle Spasticity / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D009407:Nerve Block / Q000379:methods; D010146:Pain / Q000209:etiology; D059408:Pain Management