RT Book, Section
A1 Lehmann, Lance J.
A2 Warfield, Carol A.
A2 Bajwa, Zahid H.
SR Print(0)
ID 3420545
T1 Chapter 68. Peripheral Nerve Blocks
T2 Principles & Practice of Pain Medicine, 2e
YR 2004
FD 2004
PB The McGraw-Hill Companies
PP New York, NY
SN 9780071443494
LK accessanesthesiology.mhmedical.com/content.aspx?aid=3420545
RD 2024/04/25
AB The  interruption,  interference,  or  blockade  of  painful  stimuli  has  been  used  in  the  management  of  pain  for  several  decades.  Acute,  chronic,  and  postoperative  pain  can  be  diminished  with  various  types  of  regional  anesthesia  or  specific  nerve  blocks.  In  the  setting  of  chronic  pain  management,  various  peripheral  nerve  blocks  can  be  diagnostic,  prognostic,  or  therapeutic  in  nature.  A  nerve  block  involves  the  injection  or  infusion  of  a  short-  or  long-acting  local  anesthetic  around  a  peripheral  sensory  nerve,  motor  nerve,  or  sympathetic  nerve  plexus.  In  addition  to  local  anesthetic,  a  steroid  preparation  may  be  added  to  decrease  any  suspected  inflammatory  process.  Neurolytic  nerve  blocks  can  be  performed  utilizing  various  techniques  including  chemical,  heat,  or  cold.  Chemical  agents  such  as  alcohol  or  phenol  are  used  for  the  selective  destruction  of  nerves.  Pulsed  radiofrequency  and  cryoanalgesia  cause  neurolysis  via  heat  or  cold  lesioning.  Advances  in  fluoroscopic  imaging  and  computed  tomography  (CT)  scanning  allow  direct  visualization  and  targeting  of  specific  nerves  and  nerve  plexuses.  Other  improvements  include  the  use  of  nerve  stimulators  during  interscalene  and  axillary  blocks  or  sensory  and  motor  nerve  stimulation  performed  during  radiofrequency  procedures  to  assist  in  accurate  needle  placement.