Adjuvants in peripheral nerve blocks - The current state of knowledge

Abstract

Regional anaesthetic techniques are an indispensable element of acute and postoperative pain management. The benefits of regional blocks are particularly noticeable in trauma and orthopaedic, joint reconstruction or thoracic surgical procedures. Depending on the local anaesthetic (LA) used, the duration of analgesia is limited to a maximum of 12-16 hours. There are several methods affecting the prolongation of analgesia, e.g. continuous techniques with catheters, liposomal forms of LAs or adjuvants. Due to numerous limitations and problems associated with the use of continuous techniques, lack of approval or availability of liposomal LAs, the optimal measure to prolong the duration of postoperative analgesia is the use of adjuvants. The present study aims to collect and systematise the current knowledge about the most common adjuvants used for nerve / plexus blockades and intravenous regional anaesthesia.