Why use Peripheral Nerve Blocks?
"Femoral nerve blocks technically are easy to perform and related to good quality of analgesia, fewer complications, minimal systemic effects, and improved patient outcomes. Additionally, a catheter for continuous infusion of local anesthetics can be inserted perineurally to extend the analgesia beyond the duration of single-injection blocks. Furthermore, continuous femoral nerve blockade can increase the magnitude of surgeries safely performed in the ambulatory setting while enhancing the quality of postoperative analgesia and patient satisfaction." i
"Continuous outpatient peripheral nerve catheters have the advantage of providing site-specific, dense, extended analgesia with systems and solutions that are readily available. Developing this area of anesthesia is essential to increasing the scale and scope of surgery that is compassionately performed on an outpatient basis. It is also crucial to enhancing the quality of care for surgical procedures that are already considered appropriate for ambulatory centers." ii
"Local anesthetics infused via perineural catheters have been shown to decrease opioid use and side effects, improve pain control, and in some cases, improve surgical outcome. Furthermore, patient-controlled local anesthetic administration, also called patient-controlled regional analgesia (PCRA), provides equivalent or superior analgesia with lower local anesthetic consumption compared to continuous infusions alone with a variety of perineural techniques." iii
"Use of perioperative regional anesthesia and postoperative analgesia is associated with a decrease in perioperative mortality and morbidity, including reduction of thromboembolic events, pulmonary complications, and myocardial infarction." iv
"Postoperative pain management using opioid-sparing treatments has been shown to have actual economic impacts. Current research suggests that using opioid-sparing or opioid-replacement techniques in the management of postoperative pain may have overall cost advantages over using opioid analgesics alone." v
"Our cost analysis of per case savings versus general or spinal anesthesia indicates an approximately $600.00/case savings which is in agreement with other studies." vi
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i Nielsen, K., Klein, S. & Steele, S. (2003) "Femoral nerve blocks". Techniques in Regional Anesthesia & Pain Management. 7(1): 8-17
ii Klein, S. (2002) "Beyond the hospital: continuous peripheral nerve blocks at home". Anesthesiology. 96(6): 1283-5
iii Ilfeld, B. & Enneking, F. (2003) "Ambulatory perineural local anesthetic infusion". Techniques in Regional Anesthesia & Pain Management. 7(1):48
iv Wu, C., Hsu, W., Richman, J. & Raja, S. (2004 ) "Postoperative cognitive function as an outcome of regional anesthesia and analgesia". Regional Anesthesia and Pain Medicine. 29(3)257
v Philip, B. (2002) Journal of Clinical Anesthesia "The economic impact of opioids on postoperative pain management" 14(5): 354-64
vi Hirshorn, S. (2001) "The successful use of local knee block for over 7,000 knee arthroscopies at the Florida Center for knee Surgery between 1982 and the present". A Poster Exhibit at ASRA. Vancouver, British Columbia, Canada
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