Peripheral nerve blockade for postoperative pain relief

Posted by Doctor Nguyen Duc Tho - Department of Surgical Anesthesia - Vinmec Central Park International Hospital

Peripheral nerve block (peripheral nerve block) is one of the anesthetic methods for surgery, in addition, it is also applied to analgesia in general anesthesia and especially after analgesia. surgery.

1. What is the effect of peripheral nerve blockade?

Peripheral nerve blockade will provide better pain relief for patients who limit the use of high-dose analgesics, especially morphine. help patients reduce nausea, and be more alert. Furthermore, peripheral nerve blockade can reduce the incidence of postoperative chronic pain.

2. How to do peripheral nerve blockade?

Peripheral nerves can be detected by ultrasound and under ultrasound guidance the anesthesiologist will use a needle to inject a diluted anesthetic close to the nerve under the influence of a conduction anesthetic. Sensory nerves will be blocked to help relieve pain for the patient,
Anesthesiologist may place a small plastic catheter near the nerve and inject pain medicine continuously or intermittently for long-term pain relief For patients after surgery, the analgesia can last up to 1 or several days, when the pump is stopped, the patient's feeling will fully recover within a few hours.

3. In which cases is peripheral nerve block applied?

For pain relief for most types of surgery.
Pain relief for cardiovascular surgery, thoracic surgery, breast surgery: (ESP planar anesthesia, PECS block) Pain relief for upper abdominal surgery, lower abdomen, obstetric surgery: (Compartment anesthesia: rectus abdominis muscle TAP Block, lumbago QL block) Pain relief for upper extremity surgery: (brachial plexus numbness, radial nerve, median nerve, ulnar nerve). Pain relief for lower limb surgery: (Lumbar plexus numbness, femoral nerve numbness, sciatica)

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4. Contraindications of peripheral nerve block

Absolutely: Patient refused. Infection of the anesthetic site. Severe hypotension. Increased intracranial pressure. Mitral stenosis, severe aortic valve. Bleeding disease.
Relative : Sepsis . Uncooperative patient (may be combined with anesthesia). Spine deformity.
Controversial: Had surgery in the area of anesthesia. Prolonged surgery. Massive blood loss. Interventions affecting breathing

5. Perform peripheral nerve blockade

The patient can be fully awake and given regional anesthesia at the site of the nerve block, or can be lightly, moderately, or deeply sedated, or the mind can be under general anesthesia.
The anesthesiologist will use the ultrasound machine to locate the nerve and guide it to insert the needle close to the nerve,
Through the needle the doctor can inject a single anesthetic or thread a catheter close to the wire nerve to pump anesthetic, relieve pain for a long time.

6. Unwanted effects and complications

Inadequate analgesia: peripheral nerve blockade may not completely relieve the patient's pain. Inability or difficulty to move the blocked limb. Feeling of heaviness in the extremities. Nerve damage causing temporary or permanent loss of sensation Hematoma: the needle can puncture a blood vessel, vein or artery causing a hematoma Catheter infection: in the case of a long-term catheterization, it sometimes develops cause peri-catheter infection Anesthesia poisoning due to intravascular injection.

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7. Conclusion

With advancements in means and technology, anesthesia is increasingly safe, the benefits are immense. This is a good choice for postoperative pain relief
Vinmec has been applied on most surgeries with high efficiency and patient satisfaction. Vinmec International General Hospital is a high-quality medical facility in Vietnam with a team of highly qualified medical professionals, well-trained, domestic and foreign, and experienced.
A system of modern and advanced medical equipment, possessing many of the best machines in the world, helping to detect many difficult and dangerous diseases in a short time, supporting the diagnosis and treatment of doctors the most effective. The hospital space is designed according to 5-star hotel standards, giving patients comfort, friendliness and peace of mind.

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Bài viết này được viết cho người đọc tại Sài Gòn, Hà Nội, Hồ Chí Minh, Phú Quốc, Nha Trang, Hạ Long, Hải Phòng, Đà Nẵng.