Title of article
Adjuvant Drugs for Peripheral Nerve Blocks: The Role of Alpha-2 Agonists, Dexamethasone, Midazolam, and Non-steroidal Anti-inflammatory Drugs
Author/Authors
Edinoff ، Amber N. Department of Psychiatry and Behavioral Medicine - Louisiana State University Health Science Center Shreveport , Houk ، Garrett M. School of Medicine - Louisiana State University Shreveport , Patil ، Shilpa Department of Anesthesiology - Louisiana State University Shreveport , Bangalore Siddaiah ، Harish Department of Anesthesiology - Louisiana State University Shreveport , Kaye ، Aaron J. Department of Anesthesiology and Perioperative Medicine - Medical University of South Carolina , Iyengar ، Priya Shelvan Brandeis University , Cornett ، Elyse M. Department of Anesthesiology - Louisiana State University Shreveport , Imani ، Farnad Department of Anesthesiology and Pain Medicine - Pain Research Center - Iran University of Medical Sciences , Mahmoudi ، Kamran Department of Anesthesiology - Pain Research Center - Ahvaz Jundishapur University of Medical Sciences , Kaye ، Adam M. Department of Pharmacy Practice - Thomas J. Long School of Pharmacy and Health Sciences - University of the Pacific , Urman ، Richard D. Department of Anesthesiology, Perioperative and Pain Medicine - Brigham and Women’s Hospital , Kaye ، Alan D. Department of Anesthesiology - Louisiana State University Shreveport
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Abstract
Adjuvant drugs for peripheral nerve blocks are a promising solution to acute postoperative pain and the transition to chronic pain treatment. Peripheral nerve blocks (PNB) are used in the brachial plexus, lumbar plexus, femoral nerve, sciatic nerve, and many other anatomic locations for site-specific pain relief. However, the duration of action of a PNB is limited without an adjuvant drug. The use of non-opioid adjuvant drugs for single-shot peripheral nerve blocks (sPNB), such as alpha-2 agonists, dexamethasone, midazolam, and non-steroidal anti-inflammatory drugs, can extend the duration of local anesthetics and reduce the dose-dependent adverse effects of local anesthetics. Tramadol is a weak opioid that acts as a central analgesic. It can block voltage-dependent sodium and potassium channels, cause serotonin release, and inhibit norepinephrine reuptake and can also be used as an adjuvant in PNBs. However, tramadol’s effectiveness and safety as an adjuvant to local anesthetic for PNB are inconsistent. The effects of the adjuvants on neurotoxicitymust be further evaluated with further studies to delineate the safety in their use in PNB. Further research needs to be done. However, the use of adjuvants in PNB can be a way to help control postoperative pain.
Keywords
Peripheral Nerve Block , Postoperative Pain , Adjuvant Medications , Alpha , 2 Agonists , NSAIDs , Dexamethasone , Midazolam
Journal title
Anesthesiology and Pain Medicine
Journal title
Anesthesiology and Pain Medicine
Record number
2762435
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