Hadzic's Regional Anesthesia > Part IV. New and Emerging Concepts in Peripheral Nerve Blocks: Equipment and Practice > Chapter 48. Equipment for Continuous Peripheral Nerve Blocks Holly Evans, MD, Karen C. Nielsen, MD, Roy A. Greengrass, MD, Susan M. Steele, MD

Equipment for Continuous Peripheral Nerve Blocks: Introduction

"Continuous peripheral nerve blocks (CPNBs) provide many advantages in the perioperative period.¹ These techniques provide the flexibility to prolong intraoperative anesthesia while avoiding the risks and side effects of general anesthesia. After surgery, CPNBs offer extended postoperative analgesia. When compared with parenteral opioid analgesia, CPNBs are associated with superior analgesia, reduced opioid consumption, and decreased opioid-related side effects such as postoperative nausea and vomiting, sedation, and respiratory depression.^2–12 Analgesia results are of a quality similar to epidural anesthesia results; however, CPNBs are associated with less hypotension, urinary retention, pruritus, and mobility restrictions than epidural analgesia.^8,13–15 There is also evidence supporting the beneficial effect of CPNBs on postoperative sleep patterns and cognitive function^16,17 as well as early rehabilitation.^8,9 Concurrent sympathectomy is ideal after microvascular surgery, reimplantation, and free-flap surgery^18,19 as well as for treatment of accidental intraarterial drug injection.^20–22 Extended analgesia can also be provided for chronic pain patients²³ and those requiring palliation of terminal illness.²⁴ Despite these benefits, CPNBs have historically been relatively underused techniques. These reasons for the underutilization were multifactorial; however, inadequate CPNB equipment likely contributed. Until recently, there had been few commercially..."