[Peripheral nerve blocks and spasticity. Why and how should we use regional blocks?]

Area of Science:

• Neurology
• Pain Management
• Rehabilitation Medicine

Context:

• Muscle spasticity significantly impacts patient recovery and quality of life following neurological injuries or diseases.
• Conditions include cerebrovascular lesions, traumatic brain/spine injuries, coma, multiple sclerosis, amyotrophic lateral sclerosis, and cerebral palsy.
• Painful spasticity presents a major challenge in patient rehabilitation.

Purpose:

• To explore the diagnostic, prognostic, and therapeutic applications of regional nerve blocks in managing painful spasticity.
• To highlight the feasibility of peripheral nerve blocks in outpatient or day-hospital settings.
• To detail the common peripheral nerve targets and the role of local anesthetics in assessing potential motor block effects.

Summary:

• Regional nerve blocks provide a threefold benefit (diagnostic, prognostic, therapeutic) for patients experiencing painful spasticity.
• Peripheral blocks, targeting sites like the pectoral nerve loop, median, obturator, and tibial nerves, are indicated for debilitating spasticity.
• Local anesthetic blocks serve as reversible tests to predict the effects and side effects of motor blocks, while neurolytic blocks offer effective, inexpensive treatment.

Impact:

• Peripheral nerve blocks offer a practical, cost-effective solution for managing muscle spasticity.
• These procedures can improve patient rehabilitation outcomes and reduce pain and disability.
• The use of blocks, particularly peripheral neurolytic blocks, presents an accessible treatment option for spasticity.