scholarly journals Use of Liposomal Bupivacaine in Pediatric Peripheral Nerve Blocks after Traumatic Amputation

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Gregory M. Halenda ◽  
Stylianos Voulgarelis
Keyword(s):  
Peripheral Nerve ◽  
Regional Anesthesia ◽  
Phantom Limb ◽  
Leg Pain ◽  
Traumatic Amputation ◽  
Opioid Use ◽  
Nerve Blocks ◽  
Nerve Blockade ◽  
Liposomal Bupivacaine ◽  
Peripheral Nerve Blockade

Liposomal bupivacaine has been explored for indications in regional anesthesia, but little has been reported about its use in pediatric patients. In March 2021, the FDA approved an indication for liposomal bupivacaine as an infiltrated local anesthetic in children older than the age of six. Despite this recently expanded indication, the literature lacks reports of use for peripheral nerve blockade in children. We describe a case where liposomal bupivacaine was used for femoral and sciatic nerve blocks in a 5-year-old child with traumatic amputation of his lower leg. Pain control was excellent, with no pain or opioid use reported during the first 62 hours. After the regional anesthesia subsided, the patient required in total 4 oral doses of oxycodone 0.1 mg/kg prior to discharge. The patient did not develop chronic pain or phantom limb syndrome. While liposomal bupivacaine is not currently FDA-approved for peripheral nerve blockade in children, this case highlights a potentially effective use of this drug and possible area for further investigation.

scholarly journals Severe Brachial Plexopathy after an Ultrasound-guided Single-injection Nerve Block for Total Shoulder Arthroplasty in a Patient with Multiple Sclerosis

2008 ◽  
Vol 108 (2) ◽  
pp. 325-328 ◽  
Author(s):  
Matthew D. Koff ◽  
Jeffrey A. Cohen ◽  
John J. McIntyre ◽  
Charles F. Carr ◽  
Brian D. Sites
Keyword(s):  
Multiple Sclerosis ◽  
Nervous System ◽  
Peripheral Nerve ◽  
Regional Anesthesia ◽  
Nerve Block ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Brachial Plexopathy ◽  
Nerve Blocks ◽  
Peripheral Nerve Blockade

DESPITE the known benefits of regional anesthesia for patients undergoing joint arthroplasty, the performance of peripheral nerve blocks in patients with multiple sclerosis (MS) remains controversial. MS has traditionally been described as an isolated disease of the central nervous system, without involvement of the peripheral nerves, and peripheral nerve blockade has been suggested to be safe. However, careful review of the literature suggests that MS may also be associated with involvement of the peripheral nervous system, challenging traditional teachings. There is a paucity of evidence with regard to safety in using peripheral nerve regional anesthesia in these patients. This makes it difficult to provide adequate "informed consent" to these patients. This case report describes a patient with MS who sustained a severe brachial plexopathy after a total shoulder arthroplasty during combined general anesthesia and interscalene nerve block.

Contemporary Perioperative Analgesia in Total Knee Arthroplasty: Multimodal Protocols, Regional Anesthesia, and Peripheral Nerve Blockade

2018 ◽  
Vol 31 (07) ◽  
pp. 600-604 ◽  
Author(s):  
Jonathan Neilio ◽  
Lisa Kunze ◽  
Jacob Drew
Keyword(s):  
Total Knee Arthroplasty ◽  
Peripheral Nerve ◽  
Regional Anesthesia ◽  
Knee Arthroplasty ◽  
Critical Evaluation ◽  
Nerve Blockade ◽  
Considerable Uncertainty ◽  
Perioperative Analgesia ◽  
Peripheral Nerve Blockade ◽  
Total Knee

AbstractPerioperative care of the total knee arthroplasty (TKA) patient has evolved considerably over the past decade. Among the changes driving this evolution toward shorter hospitalization and accelerated rehabilitation have been regional anesthesia, peripheral nerve blockade, and multimodal analgesia protocols. These complementary techniques are increasingly supported by scientific evidence, though considerable uncertainty persists regarding the optimal combination of strategies. Continued refinement of technique and critical evaluation is trending toward greater characterization of the comparative effectiveness of myriad options. Contemporary interdisciplinary arthroplasty care teams have the opportunity to individualize the TKA patient's perioperative pain control to optimize not only the clinical outcome but also patient satisfaction.

scholarly journals Peripheral Nerve Blockade with Combined Standard and Liposomal Bupivacaine in Major Lower‐Extremity Amputation

Pain Practice ◽  
2020 ◽  
Author(s):  
Catalina I. Dumitrascu ◽  
Nafisseh S. Warner ◽  
Thomas M. Stewart ◽  
Adam W. Amundson ◽  
Danette L. Bruns ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Peripheral Nerve ◽  
Lower Extremity Amputation ◽  
Nerve Blockade ◽  
Liposomal Bupivacaine ◽  
Peripheral Nerve Blockade ◽  
Extremity Amputation

Peripheral Nerve Blockade in the Pediatric Patient

2018 ◽  
Author(s):  
Joel Stockman ◽  
Lisa Lee
Keyword(s):  
Peripheral Nerve ◽  
Pediatric Patient ◽  
Pain Therapy ◽  
Adult Population ◽  
Nerve Blocks ◽  
Continuous Growth ◽  
Nerve Blockade ◽  
System P ◽  
Peripheral Nerve Blockade ◽  
Patient Refusal

Peripheral nerve blockade among the pediatric and adult population has seen continuous growth over the past decade. Improvements in ultrasonography and proven safety with minimal complications further the utilization of upper and lower extremity blockade. Procedures can safely be completed under general anesthesia in the pediatric patient. Catheters can be left in place to prolong blockade, allowing the patient to decrease narcotic pain medication for longer time periods. Contraindications include patient refusal, coagulopathy, and local infection. Continuous peripheral nerve blocks deliver prolonged analgesia and offer an alternative to opioid-based pain therapy for procedures with all projected pain types—mild to severe. Appropriate patient selection is necessary for ensuring safety when sending patients home with a catheter/delivery system.

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