Peripheral nerve blocks

What is it:

Peripheral nerve blocks are used in selected procedures as part of a preemptive and multimodal or balanced analgesia technique to provide safe intraoperative and postoperative analgesia with minimal side effects. The goal of preemptive analgesia is to minimize pain from surgically injured tissue by providing medications (eg, local anesthetics, nonsteroidal anti-inflammatory drugs [NSAIDs], opioids) before the surgical injury occurs and before pain is perceived.

Purpose:

Peripheral nerve blocks target the nociceptive impulses transmitted along peripheral nerves. Blocks also can be combined with additional medications to target pain at other levels. For example, NSAIDs reduce the activation of nociceptors at the site of injury and modify the cortical response, whereas, opioids relieve pain by binding to opioid receptors in the brain and spinal cord to modify the perception of pain.

How is it Done:

A nerve block needle, or a peripheral nerve catheter, is inserted in the vicinity of the relevant peripheral nerve. A continuous infusion of local anesthetic via a pump device ensures long-lasting pain relief. Clinicians with specific technical expertise are required for the administration of the nerve block, and other, equally skilled, clinicians are required to monitor patients intraoperatively and postoperatively. Nurses must be experienced in the preoperative screening and assessment of this patient population and must participate in educating patients and their family members. During the intraoperative and postoperative phases, nurses must observe patients for potential side effects and complications and be prepared to provide preventive measures and assistance with any treatment interventions.
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