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Effects of Combining Short- and Long-Acting Local Anaesthetics in Peripheral Nerve Blocks-A Systematic Review With
Jens L Temberg1, Sanja Pisljagic1, Mathias T Steensbæk1
1Department of Anaesthesiology, Copenhagen University Hospital - North Zealand, Hillerød, Denmark.
Acta Anaesthesiologica Scandinavica
|October 30, 2025
Summary
Combining short- and long-acting local anaesthetics (LA) for peripheral nerve blocks did not significantly improve analgesia duration. While combinations altered onset and duration compared to single agents, using LA alone may suffice for pain management.
Area of Science:
- Anesthesiology
- Pharmacology
- Pain Management
Background:
- Peripheral nerve blocks are crucial for surgical anesthesia and pain control.
- Local anesthetics (LA) are administered as short-acting or long-acting agents.
- Combining short- and long-acting LA aims to optimize block characteristics.
Conclusions:
- Combining short- and long-acting LA resulted in a 2.5-hour reduction in block duration versus long-acting LA alone.
- The combination extended duration by 3.5 hours compared to short-acting LA alone.
- Changes in onset time were minimal and likely not clinically significant.
- The necessity of combining LA for perioperative pain management remains uncertain, as single agents may be sufficient.
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