Paintherapy Part IV.Nerveblocks
Klinika Anestezjologii i Intensywnej Terapii WIM w Warszawie. Kierownik Kliniki: prof. dr hab. n. med. Zbigniew Rybicki Correspondence to: Klinika Anestezjologii i Intensywnej Terapii Wojskowego Instytutu Medycznego, ul. Szaserów 128, 00-909 Warszawa Source of financing: Department own sources
PedIatr Med rodz Vol 4 Numer 3, p.169-177
Past years have been marked with an increased interest in invasive treatment of acute and chronic pain. Anaesthesiologists when treating intra and postoperative pain use these methods most often. In chronic pain their use is less frequent. Depending on method used to perform the blockade it can have short or long lasting analgetic effect. Local anaesthetics are used with or without adjuvants such as clonidine, opioids, and adrenaline. In case of long-term blockade chemical substances, thermal and surgical methods are used to disrupt nervous structures. Unfortunately the scientific research has not been extensive in this field and that is the reason for them not to be popular. Invasive pain treatment is used in cases of failure of conservative methods or where side effects of the treatment were unacceptable. Presently these methods are more often required to support the pharmacological treatment in every stage of illness so they should be recognized as alternative or adjuvant methods in analgetic ladder. Besides analgetic effect short-lasting blockades are used for diagnostic purposes allowing localizing the place responsible for triggering pain experience as well as prognostic before planed long-lasting blockade. In chronic pain short lasting blocks should be avoided except for diagnostic purposes. Before application of any blockade we should consider if the benefit of the method would be greater than potential side effects.
Keywords: pain, nerve blocks, interventional pain therapy, neurolysis, sympathectomy