title: Continuous peripheral nerve blocks in acute pain management.
abstract: The indications for continuous nerve blocks for the perioperative pain management in hospitalized and ambulatory patients have extended well beyond orthopaedics. These techniques are not only used to control pain in patients undergoing major upper and lower extremity surgery, but also to provide perioperative analgesia in patients undergoing abdominal, plastic, urological, gynaecological, thoracic, and trauma surgeries. Infusion regimens of local anaesthetics and supplements must take into consideration the condition of the patient before and after surgery, the nature and intensity of the surgical stress associated with the surgery, and the possible need for immediate functional recovery. Continuous nerve blocks have proved safe and effective in reducing opioid consumption and related side-effects, accelerating recovery, and in many patients reducing the length of hospital stay. Continuous nerve blocks provide a safer alternative to epidural analgesia in patients receiving thromboprophylaxis, especially with low molecular-weight heparin.
authors.affiliation: Division of Regional Anesthesia and Acute Interventional Perioperative Pain Service, Department of Anesthesiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. chelje@anes.upmc.edu
authors.forename: J E
authors.initials: JE
authors.lastname: Chelly
authors.forename: D
authors.initials: D
authors.lastname: Ghisi
authors.forename: A
authors.initials: A
authors.lastname: Fanelli
mesh_terms: D000208:Acute Disease; D000698:Analgesia / Q000379:methods*; D000925:Anticoagulants / Q000009:adverse effects; D019643:Arthroplasty, Replacement; D006801:Humans; D009407:Nerve Block / Q000009:adverse effects / Q000379:methods*; D010146:Pain / Q000209:etiology; D059408:Pain Management; D010149:Postoperative Pain / Q000209:etiology / Q000628:therapy; D014947:Wounds and Injuries / Q000150:complications
chemical_list: D000925:Anticoagulants