Anesth Pain Med.  2014 Oct;9(4):237-249. 10.0000/apm.2014.9.4.237.

Peripheral nerve blocks for regional anesthesia in the lower extremity

• Bang SU

• KMID: 2046862
• DOI: http://doi.org/10.0000/apm.2014.9.4.237

Abstract

Historically, peripheral nerve blocks (PNBs) have not been as widely used as spinal and epidural anesthesia in the lower extremities due to difficulties inherent to the technique, resulting in an incomplete block and other complications. Recently, ultrasound machines have been used to facilitate locating peripheral nerves, resulting in a gradual increase in the utilization of PNBs. Currently, PNBs are used in sole regional anesthesia as well as for management of acute and chronic pain. PNBs have several advantages over other anesthetic techniques, such as central neuraxial blocks and general anesthesia. First of all, PNBs provide an improved peri-operative analgesia. Therefore, excessive opioid consumption is no longer necessary to control pain, and this results in fewer adverse effects, such as nausea, vomiting, pruritus, and respiratory depression. Furthermore, PNBs can be used as an alternative technique for high risk patients to whom a sympathetic blockade may lead to problems due to its little effect on hemodynamics. However, the use of PNBs also has pitfalls, such as a late onset, long preparation time, and risk of failure. There are advantages and disadvantages to using PNBs. If used on select cases with proper consideration for patient safety and satisfaction, PNBs can become commonly used, like other anesthetic techniques.

Keyword

Anesthesia; Lower extremity; Nerve block; Ultrasonography

MeSH Terms

Analgesia
Anesthesia
Anesthesia, Conduction*
Anesthesia, Epidural
Anesthesia, General
Chronic Pain
Hemodynamics
Humans
Lower Extremity*
Nausea
Nerve Block
Patient Safety
Peripheral Nerves*
Pruritus
Respiratory Insufficiency
Ultrasonography
Vomiting