Skip to main content
SpringerLink
Log in
Book cover

Key Topics in Management of the Critically Ill pp 75–85Cite as

Regional Anaesthesia in the Intensive Care Unit

  • Chapter

  • 1392 Accesses

Abstract

Pain is a common problem in Intensive Care patients. Pain is a modifiable risk factor for sleep deprivation, delirium and post-traumatic stress disorder [1–3]. Regional anaesthesia (RA) has the advantage of providing non-sedating targeted analgesia. Dynamic pain is better controlled with RA than opioid analgesia [4], assisting early mobilisation of patients [5]. RA may also decrease the incidence of chronic pain [6].

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Wilcox ME, Brummel NE, Archer K, Ely EW, Jackson JC, Hopkins RO (2013) Cognitive dysfunction in ICU patients: risk factors, predictors, and rehabilitation interventions. Crit Care Med 41:S81–S98

    Article  PubMed  Google Scholar 

  2. Banerjee A, Girard TD, Pandharipande P (2011) The complex interplay between delirium, sedation, and early mobility during critical illness: applications in the trauma unit. Curr Opin Anaesthesiol 24:195–201

    Article  PubMed  PubMed Central  Google Scholar 

  3. Lindenbaum L, Milia DJ (2012) Pain management in the intensive care unit. Surg Clin North Am 92:1621–1636

    Article  PubMed  Google Scholar 

  4. Richman JM, Liu SS, Courpas G et al (2006) Does continuous peripheral nerve block provide superior pain control to opioids? A meta-analysis. Anesth Analg 102:248–257

    Article  PubMed  Google Scholar 

  5. Stundner O, Memtsoudis SG (2012) Regional anesthesia and analgesia in critically ill patients: a systematic review. Reg Anesth Pain Med 37:537–544

    Article  CAS  PubMed  Google Scholar 

  6. Joffe AM, Hallman M, Gelinas C, Herr DL, Puntillo K (2013) Evaluation and treatment of pain in critically ill adults. Semin Respir Crit Care Med 34:189–200

    Article  PubMed  Google Scholar 

  7. Tong YC, Kaye AD, Urman RD (2014) Liposomal bupivacaine and clinical outcomes. Best Pract Res Clin Anaesthesiol 28:15–27

    Article  PubMed  Google Scholar 

  8. Ilfeld BM (2013) Liposome bupivacaine in peripheral nerve blocks and epidural injections to manage postoperative pain. Expert Opin Pharmacother 14:2421–2431

    Article  CAS  PubMed  Google Scholar 

  9. Murphy EJ (2005) Acute pain management pharmacology for the patient with concurrent renal or hepatic disease. Anaesth Intensive Care 33:311–322

    CAS  PubMed  Google Scholar 

  10. Mulroy MF (2002) Systemic toxicity and cardiotoxicity from local anesthetics: incidence and preventive measures. Reg Anesth Pain Med 27:556–561

    CAS  PubMed  Google Scholar 

  11. Weinberg GL (2010) Treatment of local anesthetic systemic toxicity (LAST). Reg Anesth Pain Med 35:188–193

    Article  CAS  PubMed  Google Scholar 

  12. Ecoffey C, Oger E, Marchand-Maillet F, Cimino Y, Rannou JJ, Beloeil H (2014) Complications associated with 27 031 ultrasound-guided axillary brachial plexus blocks: a web-based survey of 36 French centres. Eur J Anaesthesiol 31:606–610

    Article  PubMed  Google Scholar 

  13. Brull R, McCartney CJ, Chan VW, El-Beheiry H (2007) Neurological complications after regional anesthesia: contemporary estimates of risk. Anesth Analg 104:965–974

    Article  PubMed  Google Scholar 

  14. Steinfeldt T (2012) Nerve injury due to peripheral nerve blocks: pathophysiology and aetiology. Anasthesiol Intensivmed Notfallmed Schmerzther 47:328–333, quiz 34

    Article  PubMed  Google Scholar 

  15. Pandit JJ, Dutta D, Morris JF (2003) Spread of injectate with superficial cervical plexus block in humans: an anatomical study. Br J Anaesth 91:733–735

    Article  CAS  PubMed  Google Scholar 

  16. Brown DL (2010) Spinal, epidural and caudal anaesthesia. In: Miller RD, Eriksson LI, Fleisher LA, Wiener-Kronish GP, Young WL (eds) Millers’ anaesthesia, 7th edn. Elsevier Churchill Livingstone, Philadelphia, p 1624

    Google Scholar 

  17. Joshi GP, Ogunnaike BO (2005) Consequences of inadequate postoperative pain relief and chronic persistent postoperative pain. Anesthesiol Clin North America 23:21–36

    Article  PubMed  Google Scholar 

  18. Romero A, Garcia JE, Joshi GP (2013) The state of the art in preventing postthoracotomy pain. Semin Thorac Cardiovasc Surg 25:116–124

    Article  PubMed  Google Scholar 

  19. Barbosa FT, Jucá MJ, Castro AA, Cavalcante JC (2013) Neuroaxial anaesthesia for lower-limb revascularization. Cochrane Database Syst Rev 7:CD007083

    Google Scholar 

  20. Nishimori M (2012) Epidural pain relief versus systemic opioid-based pain relief for abdominal aortic surgery. Cochrane Database Syst Rev 7:CD005059.

    Google Scholar 

  21. Carrier FM, Turgeon AF, Nicole PC et al (2009) Effect of epidural analgesia in patients with traumatic rib fractures: a systematic review and meta-analysis of randomized controlled trials. Can J Anaesth 56:230–242

    Article  PubMed  Google Scholar 

  22. Chaney MA (2006) Intrathecal and epidural anesthesia and analgesia for cardiac surgery. Anesth Analg 102:45–64

    Article  CAS  PubMed  Google Scholar 

  23. Jones NL, Edmonds L, Ghosh S, Klein AA (2013) A review of enhanced recovery for thoracic anaesthesia and surgery. Anaesthesia 68:179–189

    Article  CAS  PubMed  Google Scholar 

  24. Carli F, Kehlet H, Baldini G et al (2011) Evidence basis for regional anesthesia in multidisciplinary fast-track surgical care pathways. Reg Anesth Pain Med 36:63–72

    Article  CAS  PubMed  Google Scholar 

  25. Makris M, Harrop-Griffiths W, Cook T (2013) A reply. Anaesthesia 68:1287

    Article  CAS  PubMed  Google Scholar 

  26. Schulz-Stubner S (2006) The critically ill patient and regional anesthesia. Curr Opin Anaesthesiol 19:538–544

    Article  PubMed  Google Scholar 

  27. Guedes L, Rebelo H, Oliveira R, Neves A (2012) Regional analgesia in intensive care. Rev Bras Anestesiol 62:719–730

    Article  PubMed  Google Scholar 

  28. Guay J, Choi P, Suresh S, Albert N, Kopp S, Pace NL (2014) Neuraxial blockade for the prevention of postoperative mortality and major morbidity: an overview of Cochrane systematic reviews. Cochrane Database Syst Rev 1:CD010108

    PubMed  Google Scholar 

  29. Peyton PJ, Myles PS, Silbert BS, Rigg JA, Jamrozik K, Parsons R (2003) Perioperative epidural analgesia and outcome after major abdominal surgery in high-risk patients. Anesth Analg 96:548-, table of contents

    Google Scholar 

  30. Rigg JR, Jamrozik K, Myles PS et al (2002) Epidural anaesthesia and analgesia and outcome of major surgery: a randomised trial. Lancet 359:1276–1282

    Article  PubMed  Google Scholar 

  31. Barr J, Fraser GL, Puntillo K et al (2013) Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Crit Care Med 41:263–306

    Article  PubMed  Google Scholar 

  32. Popping DM, Elia N, Van Aken HK et al (2014) Impact of epidural analgesia on mortality and morbidity after surgery: systematic review and meta-analysis of randomized controlled trials. Ann Surg 259:1056–1067

    Article  PubMed  Google Scholar 

  33. Karmakar MK (2001) Thoracic paravertebral block. Anesthesiology 95:771–780

    Article  CAS  PubMed  Google Scholar 

  34. Boezaart AP, Lucas SD, Elliott CE (2009) Paravertebral block: cervical, thoracic, lumbar, and sacral. Curr Opin Anaesthesiol 22:637–643

    Article  PubMed  Google Scholar 

  35. Dravid RM, Paul RE (2007) Interpleural block – part 1. Anaesthesia 62:1039–1049

    Article  CAS  PubMed  Google Scholar 

  36. Abdallah FW, Chan VW, Brull R (2012) Transversus abdominis plane block: a systematic review. Reg Anesth Pain Med 37:193–209

    Article  CAS  PubMed  Google Scholar 

  37. Finnerty O, McDonnell JG (2012) Transversus abdominis plane block. Curr Opin Anaesthesiol 25:610–614

    Article  PubMed  Google Scholar 

  38. Finnerty O, Carney J, McDonnell JG (2010) Trunk blocks for abdominal surgery. Anaesthesia 65(Suppl 1):76–83

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Anaesthesia, Evelina London Children’s Hospital, St Thomas’s Hospital, Westminster Bridge Road, London, SE1 7EH, UK

    Jacinda Gail Hammerschlag BSc(Wits), MBBCh(Wits), FCA(SA)

  2. Intensive Care Unit, Pietermaritzburg Department of Anaesthesia, Critical Care and Pain Management, Grey’s Hospital, Pietermaritzburg, South Africa

    Richard Peter von Rahden MBBCh(Wits), FCA(SA), (CritCare)

  3. Discipline of Anaesthesia and Critical Care, University of KwaZulu-Natal, Pietermaritzburg, South Africa

    Richard Peter von Rahden MBBCh(Wits), FCA(SA), (CritCare)

Authors
  1. Jacinda Gail Hammerschlag BSc(Wits), MBBCh(Wits), FCA(SA)
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Richard Peter von Rahden MBBCh(Wits), FCA(SA), (CritCare)
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jacinda Gail Hammerschlag BSc(Wits), MBBCh(Wits), FCA(SA) .

Editor information

Editors and Affiliations

  1. Anaesthesia and Intensive Care Medicine, Chelsea and Westminster Hospital, London, United Kingdom

    Marcela P. Vizcaychipi

  2. Cardiothoracic Anaesthesia and Intensive, St George's Hospital, London, United Kingdom

    Carlos M. Corredor

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Hammerschlag, J.G., von Rahden, R.P. (2016). Regional Anaesthesia in the Intensive Care Unit. In: Vizcaychipi, M., Corredor, C. (eds) Key Topics in Management of the Critically Ill. Springer, Cham. https://doi.org/10.1007/978-3-319-22377-3_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-22377-3_6

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-22376-6

  • Online ISBN: 978-3-319-22377-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation