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Continuous peripheral nerve block for in-patients with lower limb ischemic pain
Hermann Dos Santos Fernandes1, Jorge Luiz Saraiva Ximenes1, Paloma Kiyomi Taguchi1
1Divisao de Anestesiologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR.
Clinics (Sao Paulo, Brazil)
|February 4, 2022
Summary
Continuous peripheral nerve block (CPNB) effectively manages ischemic pain in patients with peripheral obstructive arterial disease (POAD). This method offers adequate pain relief and fewer side effects compared to traditional treatments.
Area of Science:
- Anesthesiology
- Pain Management
- Vascular Surgery
Background:
- Peripheral obstructive arterial disease (POAD) causes severe ischemic pain, often refractory to conventional analgesics.
- Opioid medications are commonly used but associated with significant side effects.
- Effective pain management is crucial for improving quality of life in POAD patients.
Purpose of the Study:
- To evaluate the efficacy and safety of continuous peripheral nerve block (CPNB) for treating ischemic pain in patients with POAD.
- To compare pain intensity and opioid consumption in patients receiving CPNB versus baseline.
Main Methods:
- Retrospective cohort study involving 21 patients with Fontaine IV POAD and foot pain.
- Continuous sciatic nerve block (CSNB) was administered via a perineural catheter.
- Pain intensity (numerical rating scale) and opioid consumption (oral morphine equivalents) were primary outcome measures.
Main Results:
- CSNB significantly reduced pain scores compared to the pre-block period.
- Patients experienced marked pain relief during the CSNB.
- The study suggests a reduction in adverse effects associated with CPNB.
Conclusions:
- Continuous peripheral nerve block is a viable alternative for managing ischemic pain in POAD patients.
- CPNB provides effective analgesia with a potentially lower incidence of side effects.
- This technique may be beneficial for in-patients requiring advanced pain control for critical limb ischemia.
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