Adjunct medications for peripheral and neuraxial anesthesia

Regional and neuraxial anesthesia can provide a safer perioperative experience, greater satisfaction, reduced opioid consumption, and reduction of pain, while minimizing side effects. Ultrasound technology has aided clinicians in depositing local anesthetic medication in precise proximity to targete...

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Bibliographic Details
Published in:Best practice & research. Clinical anaesthesiology 2018-06, Vol.32 (2), p.83-99
Main Authors: Emelife, Patrick Ifesinachi, Eng, Matthew R., Menard, Bethany L., Myers, Andrew S., Cornett, Elyse M., Urman, Richard D., Kaye, Alan D.
Format: Article
Language:English
Subjects:
adjuvant
neuraxial anesthesia
peripheral nerve block
prolongation
regional anesthesia
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Summary:Regional and neuraxial anesthesia can provide a safer perioperative experience, greater satisfaction, reduced opioid consumption, and reduction of pain, while minimizing side effects. Ultrasound technology has aided clinicians in depositing local anesthetic medication in precise proximity to targeted peripheral nerves. There are a plethora of adjuvants that have been utilized to prolong local anesthetic actions and enhance effects in peripheral nerve blocks. This manuscript describes the current state of the use of adjuncts, e.g., dexmedetomidine, dexamethasone, clonidine, epinephrine, etc., in regional anesthesia. Additionally, evidence behind dosing and block prolongation is summarized along with patient outcomes, adverse effects, and future directions.
ISSN:1521-6896
1532-169X
DOI:10.1016/j.bpa.2018.06.011