• Best Pract Res Clin Anaesthesiol · Mar 2019

    Review

    Percutaneous peripheral nerve stimulation and other alternatives for perineural catheters for postoperative analgesia.

    • Rodney A Gabriel and Brian M Ilfeld.
    • Department of Anesthesiology, University of California, 200 West Arbor Dr, MC 8770, San Diego, CA 92103, USA. Electronic address: ragabriel@ucsd.edu.
    • Best Pract Res Clin Anaesthesiol. 2019 Mar 1; 33 (1): 37-46.

    AbstractA perineural catheter with a continuous infusion of local anesthetic is an excellent option for postoperative analgesia; however, its limitations include limited duration of action (i.e., 3-7 days) as well as a risk of infection and dislodgement. Furthermore, these blocks may cause dense sensory and motor blockades that under certain circumstances may not be ideal. There is novel evidence that ultrasound-guided percutaneous peripheral nerve stimulation (pPNS) may serve as an alternative approach free of the limitations associated with peripheral nerve blocks. In this review, we discuss the evidence for pPNS on postoperative acute pain management. Subsequently, we briefly discuss additional alternatives to continuous peripheral nerve blocks, including cryoanalgesia and liposomal bupivacaine.Copyright © 2019 Elsevier Ltd. All rights reserved.

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