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Neural blockade for neuropathic pain
1Department of Anesthesiology, University of New Mexico School of Medicine, Albuquerque 87131-5216, USA. sabram@salud.unm.edu
Objective:
This study reviews the available literature regarding the use of nerve blocks for the management of peripheral neuropathy.
Design:
A MEDLINE literature review was carried out, examining the existing literature about the use of nerve blocks for the treatment of mononeuropathies and radiculopathy.
Interventions:
The study encompassed the use of local anesthetic peripheral and sympathetic nerve blocks, perineural steroid injections, and neurolytic blocks.
Results:
Local anesthetic peripheral and sympathetic blocks provide useful diagnostic information but tend to afford only temporary therapeutic benefits in patients with peripheral neuropathy. Perineural steroids provide lasting relief for some patients with radiculopathy and peripheral neuropathy, but in most studies, it is a minority of patients who experience long-term relief. Peripheral neurolytic blocks are helpful for some patients with peripheral mononeuropathy, particularly in the setting of cancer pain. Although there are the risks of exacerbating pain and serious complications, certain patients experience long-term relief.
Conclusions:
Most discussions on the management of peripheral neuropathy do not include the use of nerve blocks. Nevertheless, the nerve block procedures discussed here can play an important role in the management of these conditions.