Peripheral nerve blocks in trauma patients: Recent updates and improving patient outcomes: A narrative review

Abstract

Trauma is a significant health problem and a leading cause of death in all age groups. Pain related to trauma is severe, but is often undertreated in trauma population. Opioids are widely used to treat pain in trauma patients but being associated with undesirable effects. In contrast, regional analgesia confers excellent site-specific pain relief that is free from major side effects, reduces opioid requirement and is safe and easy to perform. Specific populations that have shown benefits (including decreased morbidity and mortality) with regional analgesic techniques include those with fractured ribs and femur and hip fractures and patients undergoing digital replantation. The use of regional anesthesia in patients at risk for compartment syndrome is controversial; although the data is sparse, there is no evidence that peripheral nerve blocks delay the diagnosis. The benefit of regional analgesia is most evident when it is initiated as early as possible. The performance of nerve blocks both in the emergency room and in the field has been shown to provide quality pain relief with an excellent safety profile.