Skip to main content

Nerve Blocks in the Treatment of Acute Pain

  • Conference paper
Advances in Pain Therapy II
  • 76 Accesses

Abstract

Nerve blocks are rarely the primary alternative in the treatment of acute pain. Intravenous or intramuscular analgesics have usually been tried first, and when the pain persists and becomes a problem, the anesthesiologist (or acute pain service) is called for consultation about more effective therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Patel JM, Lanzafame RJ, Williams JS, Mullen BV, Hinshaw JR (1983) The effect of incisional infiltration of bupivacaine hydrochloride on pulmonary function, atelectasis and narcotic need following elective cholecystectomy. Surg Gynecol Obstet 157: 338–340

    PubMed  CAS  Google Scholar 

  2. Partridge BL, Stabile BE (1990) The effects of incisional bupivacaine on postoperative narcotic requirements, oxygen saturation and length of stay in the post-anesthesia care unit. Acta Anaesthesiol Scand 34: 486–491

    Article  PubMed  CAS  Google Scholar 

  3. Ejlersen E, Andersen HB, Eliasen K, Mogensen T (1992) A comparison between preincisional and postincisional lidocaine infiltration and postoperative pain. Anesth Analg 74: 495–498

    Article  PubMed  CAS  Google Scholar 

  4. Holst P, Erichsen CJ, Dahl JB, Hjortso N-C, Grinsted J, Kehlet H (1992) Effects of lidocaine aerosol on postoperative pain and wound tenderness following minor gynaecological laparotomy. Acta Anaesthesiol Scand 36: 112–114

    Article  PubMed  CAS  Google Scholar 

  5. Levack ID, Holmes JD, Robertson GS (1986) Abdominal wound perfusion for the relief of postoperative pain. Br J Anaesth 58: 615–619

    Article  PubMed  CAS  Google Scholar 

  6. Rosenberg PH, Renkonen OV (1985) Antimicrobial activity of bupivacaine and morphine. Anesthesiology 62: 178–179

    Article  PubMed  CAS  Google Scholar 

  7. Tuominen M, Haasio J, Hekali R, Rosenberg PH (1989) Continuous interscalene brachial plexus block: clinical efficacy, technical problems and bupivacaine plasma concentrations. Acta Anaesthesiol Scand 33: 84–88

    Article  PubMed  CAS  Google Scholar 

  8. Pere P, Tuominen M, Rosenberg PH (1991) Cumulation of bupivacaine, desbutylbu-pivacaine and 4-hydroxybupivacaine during and after continuous interscalene brachial plexus block. Acta Anaesthesiol Scand 35: 647–650

    Article  PubMed  CAS  Google Scholar 

  9. Urmey WF, Talts KH, Sharrock NE (1991) One hundred percent incidence of hemidiaphragmatic paresis associated with interscalene brachial plexus anesthesia as diagnosed by ultrasonography. Anesth Analg 72: 498–503

    Article  PubMed  CAS  Google Scholar 

  10. Pere P, Pitkänen M, Rosenberg PH, Björkenheim J-M, Linddn H, Salorinne Y, Tuominen M (1992) Effect of continuous interscalene brachial plexus block on diaphragm motion and on ventilatory function. Acta Anaesthesiol Scand 36: 53–57

    Article  PubMed  CAS  Google Scholar 

  11. Gobeaux D, Landais A, Bexon G, Cabazan J, Levron JC (1987) Adjontion de fentanyl a la lidocaine adrenaline pour le blocage du plexus brachial. Cah Anesthesiol 35: 195–199

    PubMed  CAS  Google Scholar 

  12. Viel EJ, Eledjam JJ, De la Coussaye JE, D’Athis F (1989) Brachial plexus block with opioids for postoperative pain relief: comparison between buprenorphine and morphine. Reg Anesth 14: 274–278

    PubMed  CAS  Google Scholar 

  13. Tryba M, Lammers TJ, Wedel DJ, Rose S (1992) Clonidine prolongs the duration of analgesia after prilocaine for axillary plexus block; a randomized controlled doubleblind study. Reg Anesth 17 [Suppl 1]: 16

    Google Scholar 

  14. Sukhani R, Winnie AP (1987) Clinical pharmacokinetics of carbonated local anesthetics II: interscalene brachial block model. Anesth Analg 66: 1245–1250

    PubMed  CAS  Google Scholar 

  15. Quinlan JJ, Oleksey K, Murphy FL (1992;) Alkalinization of mepivacaine for axillary block. Anesth Analg 74: 371–374

    Article  PubMed  CAS  Google Scholar 

  16. Nunn JF, Slavin G (1980) Posterior intercostal nerve block for pain relief after cholecystectomy. Anatomical basis and efficacy. Br J Anaesth 52: 253–259

    Article  PubMed  CAS  Google Scholar 

  17. Murphy DF (1983) Continuous intercostal nerve blockade for pain relief following cholecystectomy. Br J Anaesth 55: 521–525

    Article  PubMed  CAS  Google Scholar 

  18. Murphy DF (1984) Continuous intercostal nerve blockade. An anatomical study to eludicate its mode of action. Br J Anaesth 56: 627–629

    Article  PubMed  CAS  Google Scholar 

  19. Katz J, Nelson W, Forest R, Bruce DL (1980) Cryoanalgesia for post-thoracotomy pain. Lancet 1: 512–513

    Article  PubMed  CAS  Google Scholar 

  20. Eason MJ, Wyatt R (1979) Paravertebral thoracic block — a reappraisal. Anaesthesia 34: 638–642

    Article  PubMed  CAS  Google Scholar 

  21. Strømskag KE, Hauge O, Steen PA (1990) Distribution of local anaesthetics injected in the intrapleural space studied by computerized tomography. Acta Anaesthesiol Scand 35: 323–326

    Article  Google Scholar 

  22. Brismar B, Pettersson N, Tokics L, Strandberg A, Hedenstierna G (1987) Postoperative analgesia with intrapleural administration of bupivacaine-adrenaline. Acta Anaesthesiol Scand 31: 515–520

    Article  PubMed  CAS  Google Scholar 

  23. Strømskag KE, Reiestad F, Holmqvist ELO, Ogenstad S (1988) Intrapleural administration of 0.25%, 0.375%, and 0.5% bupivacaine with epinephrine after cholecystectomy. Anesth Analg 67: 430–434

    PubMed  Google Scholar 

  24. Rosenberg PH, Scheinin BM-A, Lepäntalo MJA, Lindfors O (1987) Continuous intrapleural infusion of bupivacaine for analgesia after thoracotomy. Anesthesiology 67: 811–813

    Article  PubMed  CAS  Google Scholar 

  25. Scheinin B, Lindgren L, Rosenberg PH (1989) Treatment of post-thoracotomy pain with intermittent instillations of intrapleural bupivacaine. Acta Anaesthesiol Scand 33: 156–159

    Article  PubMed  CAS  Google Scholar 

  26. Durrani Z, Winnie AP, Ikuta P (1988) Interpleural catheter analgesia for pancreatic pain. Anesth Analg 67: 479–481

    Article  PubMed  CAS  Google Scholar 

  27. Reiestad F, McIlvane WB, Kvalheim L, Stokke T, Pettersen B (1989) Interpleural analgesia in treatment of upper extremity reflex sympathtetic dystrophy. Anesth Analg 69: 671–673

    PubMed  CAS  Google Scholar 

  28. Anker-Møller E, Spangsberg N, Dahl JB, Christensen EF, Schultz P, Carlsson P (1990) Continuous blockade of the lumbar plexus after knee surgery: a comparison of the plasma concentrations and analgesic effect of bupivacaine 0.25% and 0.125%. Acta Anaesthesiol Scand 34: 468–472

    Article  PubMed  Google Scholar 

  29. Smith BE, Fischer HBJ, Scott PV (1984) Continuous sciatic nerve block. Anaesthesia 39: 155–157

    Article  PubMed  CAS  Google Scholar 

  30. Heard SO, Edwards WT, Ferrari D, Hanna D, Wong PD, Liland A, Willock MM (1992) Analgesic effect of intraarticular bupivacaine after arthroscopic knee surgery: a randomized, prospective, double-blind study. Anesth Analg 74: 822–826

    Article  PubMed  CAS  Google Scholar 

  31. Henderson RC, Campion ER, DeMasi RA, Taft TN (1990) Postarthroscopy analgesia with bupivacaine. A prospective, randomized, blinded evaluation. Am J Sports Med 18: 614–617

    Article  PubMed  CAS  Google Scholar 

  32. Stein C, Comisel K, Haimerl E, Yassouridis A, Lehrberger K, Herz A, Peter K (1991) Analgesic effect of intraarticular morphine after arthroscopic knee surgery. N Engl J Med 325: 1123–1125

    Article  PubMed  CAS  Google Scholar 

  33. Dickstein R, Raja SN, Johnson C (1991) Comparison of intraarticular bupivacaine and morphine for analgesia following arthroscopic knee surgery. Anesthesiology 75: A768

    Article  Google Scholar 

  34. Behar M, Magora F, Olshwang D, Davidson JT (1979) Epidural morphine in treatment of pain. Lancet 1: 527–528

    Article  PubMed  CAS  Google Scholar 

  35. Wang JK, Nauss AL, Thomas JE (1979) Pain relief by intrathecally applied morphine in man. Anesthesiology 50: 149–151

    Article  PubMed  CAS  Google Scholar 

  36. Asantila R, Eklund P, Rosenberg PH (1991) Continuous epidural infusion of bupivacaine and morphine for postoperative analgesia after hysterectomy. Acta Anaesthesiol Scand 35: 513–517

    Article  PubMed  CAS  Google Scholar 

  37. Ready LB, Loper KA, Nessley BS, Wild L (1991) Postoperative epidural morphine is safe on surgical wards. Anesthesiology 75: 452–456

    Article  PubMed  CAS  Google Scholar 

  38. Shimomura K, Kamata O, Ueki S, Ida S, Oguri K, Yoshimura H, Tsukamoto H (1971) Analgesic effect of morphine glucuronides. Tohuko J Exp Med 105: 45–52

    Article  CAS  Google Scholar 

  39. Sandler AN, Stringer D, Panos L, Badner N, Friedlander M, Koren G, Katz J, Klein J (1992) A randomized, double-blind comparison of lumbar epidural and intravenous fentanyl infusions for postthoracotomy pain relief: analgesic, pharmacokinetic, and respiratory effects. Anesthesiology 77: 626–634

    Article  PubMed  CAS  Google Scholar 

  40. Salomäki TE, Laitinen JO, Nuutinen LS (1991) A randomized double-blind comparison of epidural versus intravenous fentanyl infusion for analgesia after thoracotomy. Anesthesiology 75: 790–795

    Article  PubMed  Google Scholar 

  41. Camu F, Debycquoy F (1991) Alfentanil infusion for postoperative pain: comparison of epidural and intravenous routes. Anesthesiology 75: 171–178

    Article  PubMed  CAS  Google Scholar 

  42. Cohen SE, Tan S, White PE (1988) Analgesia following cesarean section: epidural versus intravenous administration. Anesthesiology 68: 129–134

    Article  PubMed  CAS  Google Scholar 

  43. Breivik H (1992) Epidural opioids: current use. Curr Opin Anaesthesiol 5: 661–665

    Article  Google Scholar 

  44. Camann WR, Hartigan PM, Gilbertson LI, Johnston MD, Datta S (1990) Chloroprocaine antagonism of epidural opioid analgesia: a receptor-specific phenomenon. Anesthesiology 73: 860–863

    Article  PubMed  CAS  Google Scholar 

  45. Abboud TK, Zhu J, Afrasiaba A, Reyes A, Sherman G, Kahn R, Vera Cruz R, Steffens Z (1991) Epidural butorphanol augments lidocaine sensory anesthesia during labor. Reg Anesth 16: 265–267

    PubMed  CAS  Google Scholar 

  46. Elliott RD (1991) Continuous infusion epidural analgesia for obstetrics: bupivacaine versus bupivacaine-fentanyl mixture. Can J Anaesth 38: 303–310

    Article  PubMed  CAS  Google Scholar 

  47. Brownridge P, Plummer J, Mitchell J, Marshall P (1992) An evaluation of epidural bupivacaine with and without meperidine in labor. Reg Anesth 17: 15–21

    PubMed  CAS  Google Scholar 

  48. Vertommen JD, Vandermeulen E, Van Aken H, Vaes L, Soetens M, Van Steenberge A, Mourisse P, Willaert J, Noordun H, Devlieger H, Van Assche F (1991) Effects of the addition of sufentanil to 0.125% bupivacaine on the quality of analgesia during labor and on the incidence of instrumental deliveries. Anesthesiology 74: 809–814

    Article  PubMed  CAS  Google Scholar 

  49. Dahl JB, Rosenberg J, Hansen BL, Hjortsø N-C, Kehlet H (1992) Differential analgesic effects of low-dose epidural morphine and morphine-bupivacaine at rest and during mobilization after major abdominal surgery. Anesth Analg 74: 362–365

    Article  PubMed  CAS  Google Scholar 

  50. Maves TJ, Gebhart GF (1992) Antinociceptive synergy between intrathecal morphine and lidocaine during visceral and somatic nociception in the rat. Anesthesiology 76: 91–99

    Article  PubMed  CAS  Google Scholar 

  51. Sullivan AF, Kalso EA, McQuay HJ, Dickenson AH (1992) Evidence for the involvement of the μ but not 8 opioid receptor subtype in the synergistic interaction between opioid and a2 adrenergic antinociception in the rat spinal cord. Neurosci Lett 136: 65–68

    Article  Google Scholar 

  52. Bailey PL, Sperry RJ, Johnson GK, Eldredge SJ, East KA, East TD, Pace NL, Stanley TH (1991) Respiratory effects of clonidine alone and combined with morphine, in humans. Anesthesiology 74: 43–48

    Article  PubMed  CAS  Google Scholar 

  53. Rostaing S, Bonnet F, Levron JC, Vodinh J, Pluskwa F, Saada M (1991) Effect of epidural clonidine on analgesia and pharmacokinetics of epidural fentanyl in post-operative patients. Anesthesiology 75: 420–425

    Article  PubMed  CAS  Google Scholar 

  54. Bonnet F, Boico O, Rostaing S, Saada M, Loriferne JF, Toubul C, Abhay K, Ghignone M (1989) Postoperative analgesia with extradural clonidine. Br J Anaesth 63: 465–469

    Article  PubMed  CAS  Google Scholar 

  55. Racle JP, Benkharda A, Poy JY, Gleizal B (1987) Prolongation of isobaric bupivacaine spinal anesthesia with epinephrine and clonidine for hip surgery in the elderly. Anesth Analg 66: 442–446

    PubMed  CAS  Google Scholar 

  56. Carabine UA, Milligan KR, Moore J (1992) Extradural clonidine and bupivacaine for postoperative analgesia. Br J Anaesth 68: 132–135

    Article  PubMed  CAS  Google Scholar 

  57. Hurley RJ, Lambert DH (1990) Continuous spinal anesthesia with microcatheter technique: preliminary experience. Anesth Analg 70: 97–102

    Article  PubMed  CAS  Google Scholar 

  58. Pitkänen M (1992) Continuous spinal anaesthesia. Curr Opin Anaesthesiol 5: 676–680

    Article  Google Scholar 

  59. Rawal N, Arnér S, Gustafsson LL, Allvin R (1987) Present state of extradural and intrathecal opioid analgesia in Sweden. Br J Anaesth 59: 791–799

    Article  PubMed  CAS  Google Scholar 

  60. Kalso E (1983) Effects of intrathecal morphine, injected with bupivacaine, on pain after orthopaedic surgery. Br J Anaesth 55: 415–422

    Article  PubMed  CAS  Google Scholar 

  61. Bengtsson M, Löfström JB, Merits H (1983) Postoperative pain relief with intrathecal morphine after major hip surgery. Reg Anesth 8: 138–143

    Google Scholar 

  62. Belzarena SD (1992) Clinical effects of intrathecally administered fentanyl in patients undergoing cesarean section. Anesth Analg 74: 653–657

    Article  PubMed  CAS  Google Scholar 

  63. Rawal N, Nuutinen L, Raj PP, Lovering SL, Gobuty AH, Hargardine J, Lehmkuhl L, Herva R, Abouleish E (1991) Behavioral and histopathologic effects following intrathecal administration of butorphanol, sufentanil, and nalbuphine in sheep. Anesthesiology 75: 1025–1034

    Article  PubMed  CAS  Google Scholar 

  64. Acalovschi I, Ene V, Lörinchi E, Nicolaus F (1986) Saddle block with pethidine for perineal operations. Br J Anaesth 58: 1012–1016

    Article  PubMed  CAS  Google Scholar 

  65. McQuay HJ (1992) Editorial: Pre-emptive analgesia. Br J Anaesth 69: 1–3

    Article  PubMed  CAS  Google Scholar 

  66. Coderre TJ, Vaccarino AL, Melzack R (1990) Central nervous system plasticity in the tonic pain response to subcutaneous formalin injection. Brain Res 535: 155–158

    Article  PubMed  CAS  Google Scholar 

  67. Tverskoy M, Cozacov C, Ayache M, Bradley EL, Kissin I (1990) Postoperative pain after inguinal hernioraphy with different types of anesthesia. Anesth Analg 70: 29–35

    Article  PubMed  CAS  Google Scholar 

  68. Dierking GW, Dahl JB, Kanstrup J, Dahl A, Kehlet H (1992) Effect of pre- vs postoperative inguinal field block on postoperative pain after hernioraphy. Br J Anaesth 68: 344–348

    Article  PubMed  CAS  Google Scholar 

  69. Bonica JJ (1990) Causalgia and other reflex sympathetic dystrophies. In: Bonica JJ (ed) The management of pain. Lea and Febiger, Philadelphia, pp 220–243

    Google Scholar 

  70. Klassen GA, Bramwell RS, Bromage PR, Zborowska-Sluis DT (1980) Effect of acute sympathectomy by epidural anesthesia on the canine coronary circulation. Anesthesiology 52: 8–15

    Article  PubMed  CAS  Google Scholar 

  71. Bonica JJ, Buckley FP (1990) Regional analgesia with local anesthetics. In: Bonica JJ (ed) The management of pain, 2nd edn. Lea and Febiger, Philadelphia, pp 1934–1937

    Google Scholar 

  72. Parris WCV, Dettbarn WD (1989) Muscle atrophy following bupivacaine trigger point injection. Anesthesiol Rev 16: 50–53

    Google Scholar 

  73. Foster AH, Carlson BM (1980) Myotoxicity of local anesthetics and regeneration of the damaged muscle fibers. Anesth Analg 59: 727–736

    Article  PubMed  CAS  Google Scholar 

  74. Scott DB (1990) Acute pain management. In: Cousins MJ, Bridenbaugh PO (eds) Neural blockade in clinical anesthesia and management of pains 2nd edn. Lippincott, Philadelphia, p 862

    Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1993 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Rosenberg, P.H. (1993). Nerve Blocks in the Treatment of Acute Pain. In: Chrubasik, J., Martin, E., Cousins, M.J. (eds) Advances in Pain Therapy II. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-78341-8_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-78341-8_8

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-56917-6

  • Online ISBN: 978-3-642-78341-8

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics