Episode 14: Additives for Peripheral Nerve Blocks

Raj Gupta (@dr_rajgupta) and Eric Schwenk (@ESchwenkMD) discuss the value and risks of additives used to extend analgesia with peripheral nerve blocks.  Our guests for this show are Chad Brummett (@drchadb) from the University of Michigan and Brian Williams (williamsba@umpc.edu) from the University of Pittsburgh Medical Center and the VA Pittsburgh Healthcare System.  

Selected References

1. Brummett, C. M., & Williams, B. A. (2011). Additives to local anesthetics for peripheral nerve blockade. International Anesthesiology Clinics, 49(4), 104–116. http://doi.org/10.1097/AIA.0b013e31820e4a49
2. Marhofer, P., & Brummett, C. M. (2016). Safety and efficiency of dexmedetomidine as adjuvant to local anesthetics. Current Opinion in Anaesthesiology, 29(5), 632–637. http://doi.org/10.1097/ACO.0000000000000364
3. Williams, B. A., Butt, M. T., Zeller, J. R., Coffee, S., & Pippi, M. A. (2015). Multimodal perineural analgesia with combined bupivacaine-clonidine-buprenorphine-dexamethasone: safe in vivo and chemically compatible in solution. Pain Medicine (Malden, Mass.), 16(1), 186–198. http://doi.org/10.1111/pme.12592
4. Williams, B. A., Hough, K. A., Tsui, B. Y. K., Ibinson, J. W., Gold, M. S., & Gebhart, G. F. (2011). Neurotoxicity of adjuvants used in perineural anesthesia and analgesia in comparison with ropivacaine. Regional Anesthesia and Pain Medicine, 36(3), 225–230. http://doi.org/10.1097/AAP.0b013e3182176f70

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Thanks to The Preps from Philadelphia, PA for the music: “The Grind (9 to 5)" and "Unknown Night". The band features Steve Breslin on vocals/guitars, Bryan Schwenk on guitars/vocals, Jeff Frederick on bass, and Eric Schwenk on drums.