Peripheral nerve catheters: A critical review of the efficacy

Hauritz, Rasmus Wulff; Hannig, Kjartan Eskjær; A, Balocco; Peeters, Gwendolyne; Hadžić, Admir; Børglum, Jens; Bendtsen, Thomas Fichtner

doi:10.1016/j.bpa.2019.07.015

Cited by 22 publications

(23 citation statements)

References 103 publications

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“…However, the overall value of outpatient PNB catheters is controversial [68]. Continuous RA techniques are technically more challenging to perform, have an inherent failure rate [69], are time and labor-intensive to manage, and consequently are likely to remain under-utilized in this setting [68].…”

Section: Continuous Pnb Catheter Techniquesmentioning

confidence: 99%

Managing rebound pain after regional anesthesia

Muñoz-Leyva

Cubillos

Chin

2020

Korean J Anesthesiol

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Rebound pain after regional anesthesia can be defined as transient acute postoperative pain that ensues following resolution of sensory blockade, and is clinically significant, either with regard to the intensity of pain or the impact on psychological well-being, quality of recovery, and activities of daily living. Current evidence suggests that it represents an unmasking of the expected nociceptive response in the absence of adequate systemic analgesia, rather than an exaggerated hyperalgesic phenomenon induced by local anesthetic neural blockade. In the majority of patients, it does not appear to significantly impact cumulative postoperative opioid consumption, quality of recovery, or patient satisfaction, and is not associated with longer-term sequelae such as persistent post-surgical pain. Nevertheless, it must be considered whenever regional anesthesia is incorporated into perioperative management. Strategies to mitigate the impact of rebound pain include routine prescribing of a systemic multimodal analgesic regimen, as well as patient education on appropriate expectations regarding block offset and expected surgical pain, and timely initiation of analgesic medication. Prolonging the duration of action of regional anesthesia with continuous catheter techniques or local anesthetic adjuncts may also help alleviate rebound pain, although further research is required to confirm this.

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Section: Continuous Pnb Catheter Techniquesmentioning

confidence: 99%

Managing rebound pain after regional anesthesia

Muñoz-Leyva

Cubillos

Chin

2020

Korean J Anesthesiol

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“…Due to the relatively short duration of single-shot nerve blocks, continuous catheter-based techniques emerged as a theoretically superior analgesic option. However, as they are technically more challenging and are associated with higher failure rates,40 41 their role may be limited. Typical analgesic regimens for TKA are now increasingly multimodal and incorporate preoperative medications such as acetaminophen or COX-inhibitors, local infiltration or peripheral nerve blockade, and neuraxial anesthesia to promote analgesia and rehabilitation 38 42.…”

Section: Discussionmentioning

confidence: 99%

Analgesic benefits of single-shot versus continuous adductor canal block for total knee arthroplasty: a systemic review and meta-analysis of randomized trials

Hussain

Brull

Zhou

et al. 2022

Reg Anesth Pain Med

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BackgroundAdductor canal block (ACB) can provide important analgesic benefits following total knee arthroplasty (TKA), however, the extent to which these benefits can be enhanced or prolonged by a continuous catheter-based infusion compared with a single-shot injection of local anesthetic is unclear.ObjectivesThis systematic review and meta-analysis (PROSPERO: CRD42021292738) review sought to compare the analgesic effectiveness of single shot to continuous ACB following TKA.Evidence reviewWe sought randomized trials from the US National Library of Medicine database (MEDLINE), Excerpta Medica database (EMBASE), and Cochrane Database of Systematic Reviews from inception to November 1, 2021, that compared single-shot to continuous ACB in adult patients undergoing TKA. The primary outcomes were (1) area under the curve (AUC) pain severity at rest and (2) cumulative opioid (oral morphine equivalent) consumption during the first 48 hours postoperatively. Secondary outcomes included postoperative pain severity scores up to 48 hours, cumulative opioid consumption at 24 hours, functional recovery, opioid-related side effects, and block-related complications. Risk of bias of included studies was assessed using the Cochrane risk of bias tool. Statistical pooling was conducted using the Hartung-Knapp-Sidik-Jonkman method for random effects. No funding was obtained for this review.FindingsEleven trials (1185 patients) were included. No differences were observed in rest pain severity (AUC) or cumulative opioid consumption up to 48 hours postoperatively. In addition, no differences were observed in individual postoperative rest pain scores in the recovery room and at 12 and 24 hours, or in cumulative opioid consumption at 24 hours, functional recovery, and opioid-related side effects. Finally, fewer block-related complications were observed with single-shot ACB, with an OR (95% CI) of 0.24 (0.14 to 0.41) (p=0.002).ConclusionsOur results suggest that continuous catheter-based ACB does not enhance or prolong the analgesic benefits when compared with single-shot ACB for TKA over the first 48 hours postoperatively. Overall, the results of our meta-analysis do not support the routine use of continuous ACB for postoperative analgesia after TKA.

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“…The catheter often stops functioning even if it was correctly placed from the beginning. 4 It could happen in 20-30% of the patients within the first 24-48 hours. However the numbers are difficult to interpret.…”

Section: Sp65 Tips and Tricks To Place And Maintain Perineural Cathet...mentioning

confidence: 99%

SP65 Tips and tricks to place and maintain perineural catheters and avoid complications

Bergek

2022

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Peripheral nerve catheters: A critical review of the efficacy

Cited by 22 publications

References 103 publications

Managing rebound pain after regional anesthesia

Managing rebound pain after regional anesthesia

Analgesic benefits of single-shot versus continuous adductor canal block for total knee arthroplasty: a systemic review and meta-analysis of randomized trials

SP65 Tips and tricks to place and maintain perineural catheters and avoid complications

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