Indications and management of continuous infusion of local anesthetics at home.
OBJECTIVE
The review examines recent research activity in the field of continuous peripheral nerve blocks in the ambulatory setting and places it in context with regard to previous research efforts.


RESULTS
Use of continuous peripheral nerve blocks at home following outpatient surgery is an increasingly accepted form of anesthesia practice. Researchers continue active investigation of optimal strategies for the relationship between continuous local anesthetic infusion volume and concentration as well as assisted and ideal catheter placement techniques including ultrasound.


CONCLUSIONS
Continuous peripheral nerve blockade at home offers good short-term control of postoperative pain in the outpatient setting. Long-term outcomes remain to be evaluated fully. More information is becoming available on local anesthetic volume and concentration relationships in both the upper and lower extremities--optimal strategies are not yet clear. Ultrasound may offer benefits in terms of speed and ease of continuous catheter placement while reducing the necessary number of needle passes required to reach the target structure site(s).
Axley
Michael
M
Oregon Health & Science University, Oregon 97239-3098, USA.
Horn
Jean-Louis
JL
D000553:Ambulatory Care; D000556:Ambulatory Surgical Procedures; D000779:Anesthetics, Local / Q000008:administration & dosage*; D057785:Catheters; D006699:Home Care Services; D006801:Humans; D007262:Infusions, Intravenous; D035002:Lower Extremity / Q000000981:diagnostic imaging / Q000294:innervation; D009407:Nerve Block; D010525:Peripheral Nerves / Q000187:drug effects; D014463:Ultrasonography; D034941:Upper Extremity / Q000000981:diagnostic imaging / Q000294:innervation
D000779:Anesthetics, Local