Anesthesia as Pain Treatment


The current evidence supports infusions of local anesthetics at the surgical site, continuous peripheral nerve blocks, and neuraxial analgesia for major thoracic and abdominal procedures. Ultrasound guidance can improve the performance of the blocks and different patient outcomes, although the incidence of peripheral nerve damage is not decreased. For chronic pain, the best available evidence is on nerve blocks for the diagnosis of facet joint pain. Further research is needed to validate diagnostic nerve blocks for other indications. Therapeutic blocks with only local anesthetics (greater occipital nerve and sphenopalatine ganglion) are effective in headache. A possible mechanism is modulation of central nociceptive pathways. Therapeutic nerve blocks for other indications are mostly supported by retrospective studies and case series.



 


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