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Peripheral neural blockade for pain control in patients undergoing percutaneous angioplasty for complex

Abdulrahman Naser1, Khagani Isgandarov1, İlker İtal1

  • 1Department of Cardiology, Vm Medical Park Pendik Hospital, İstanbul, Turkey.

Turk Kardiyoloji Dernegi Arsivi : Turk Kardiyoloji Derneginin Yayin Organidir
|June 9, 2021
PubMed

Insights

Ultrasound-guided peripheral nerve blockade (PNB) effectively manages pain during complex infrapopliteal arterial interventions for chronic limb-threatening ischemia. This approach offers excellent pain control and improves patient outcomes in challenging endovascular procedures.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Pain Management

Background:

  • Percutaneous transluminal angioplasty is the primary revascularization method for chronic limb-threatening ischemia (CLTI) and infrapopliteal (IP) arterial disease.
  • Complex IP interventions require prolonged procedures with multiple balloon inflations and contrast injections, often causing significant patient discomfort.
  • Conventional pain management (local anesthesia, systemic opioids) is frequently insufficient for these complex cases.

Observation:

  • Ultrasound-guided peripheral nerve blockade (PNB) has emerged as a potential alternative for pain management in peripheral vascular procedures.
  • Previous studies showed PNB efficacy in less complex interventions.
  • This series reports on 4 patients undergoing PNB for complex IP endovascular treatment.

Findings:

  • Peripheral nerve blockade provided excellent periprocedural pain control in all 4 patients.
  • The PNB approach facilitated the complex endovascular procedures.
  • Patients experienced satisfactory postprocedural outcomes attributed to effective pain management.

Implications:

  • Ultrasound-guided PNB is a viable and effective strategy for managing pain during complex infrapopliteal endovascular interventions.
  • This technique can enhance patient comfort and potentially improve procedural success in challenging CLTI cases.
  • Further research validating PNB in larger cohorts for complex IP disease is warranted.

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