Hadzic's Regional Anesthesia > Part IV. New and Emerging Concepts in Peripheral Nerve Blocks: Equipment and Practice > Chapter 49. Stimulating Catheters André P. Boezaart, MD

Stimulating Catheters: Introduction

"It has been well established that peripheral nerve blocks and neuraxial blocks provide superior analgesia for the treatment of acute pain, especially postoperative pain. The main limitation of these modalities is that acute postoperative pain usually outlasts the relief afforded by single-injection techniques. As a result, continuous peripheral nerve blocks have been developed to overcome these limitations, to extend analgesia beyond duration of a single-injection method, and to allow for greater ability to titrate sensory–motor differentiation of the blockade. Unlike the case for single-injection techniques, continuous nerve block via a perineural catheter, can be discontinued or the infusion changed if unwanted side effects occur. The main emphasis during the past decade has been to develop catheters and techniques that allow relatively simple, accurate, and noninvasive catheter placement to ensure effectiveness and to reduce secondary block failure. These aims have been largely accomplished in the past decade; the current efforts seek to define indications and infusion strategies for continuous peripheral nerve blocks, especially in the setting of outpatient surgery...."