Continuous peripheral nerve blocks for pain control after orthopaedic surgery

Ana EspinozaPatricio A. LeytonMarcia RoblesJaviera VargasLoreto A. Muñoz2025-02-262025-02-262025-01-23https://investigadores.udd.cl/handle/123456789/1070710.1097/EA9.0000000000000067 BACKGROUND Continuous peripheral nerve blocks (CPNB) provide an opioid-free alternative for pain control after orthopaedic surgery. However, postdischarge ambulatory patient care and follow-up concerns have prevented CPNB use at home. OBJECTIVE To address physicians’ concerns about the outpatient use of CPNB. DESIGN Prospective, cohort, observational study. SETTING Single centre, teaching private hospital in Santiago, Chile, between July 2016 and March 2020. PATIENTS We included patients aged at least 18 who underwent orthopaedic surgery using CPNB for postoperative pain management. Patients scheduled simultaneously for non-orthopedic surgery on the same event were excluded. MAIN OUTCOME MEASURES Pain scores, opioid use, and complication rates at both in-hospital and at-home sites. RESULTS CPNB were provided as an analgesia plan in 497 patients who met inclusion criteria, and 387 (77.87%) were discharged home with this continuous analgesia. At 48 h, 70% of the patients reported no-worse-than-mild pain. Less than 3.1% of patients reported an episode of severe pain, and less than 13% of the patients required opioid rescue medication. Transient neurological symptoms were observed in 13% (95% confidence interval (CI), 10.4 to 16.1) of the patients. No long-term or severe complications were observed. High rates of satisfaction were reached among patients. CONCLUSION In-hospital and at-home use of CPNB supervised by a pain service team provides a feasible and safe alternative after orthopaedic surgery, pain control with a low requirement of opioids. Continuous peripheral nerve blocks for pain control after orthopaedic surgeryjournal-article