Indications and management of continuous infusion of local anesthetics at home

作者：Axley Michael; Horn Jean Louis^*

来源：Current Opinion in Anaesthesiology, 2010, 23(5): 650-655.

DOI：10.1097/ACO.0b013e32833e27bc

• ambulatory continuous peripheral nerve blocks
• ambulatory patient-controlled regional analgesia
• ambulatory perineural local anesthetic infusion
• ambulatory surgery

Purpose of review
The review examines recent research activity in the field of continuous peripheral nerve blocks in the ambulatory setting and places it in context with regard to previous research efforts.
Recent findings
Use of continuous peripheral nerve blocks at home following outpatient surgery is an increasingly accepted form of anesthesia practice. Researchers continue active investigation of optimal strategies for the relationship between continuous local anesthetic infusion volume and concentration as well as assisted and ideal catheter placement techniques including ultrasound.
Summary
Continuous peripheral nerve blockade at home offers good short-term control of postoperative pain in the outpatient setting. Long-term outcomes remain to be evaluated fully. More information is becoming available on local anesthetic volume and concentration relationships in both the upper and lower extremities - optimal strategies are not yet clear. Ultrasound may offer benefits in terms of speed and ease of continuous catheter placement while reducing the necessary number of needle passes required to reach the target structure site(s).

• 出版日期2010-10