Peripheral Nerve Blocks

Problem and Need for the Study

Postoperative pain is an important concern for the millions of patients who undergo elective surgeries each year. Out of the pain management strategies available, opioids are the mainstay, despite their potential for opioid-related adverse events and long-term postoperative opioid use.

Peripheral nerve blocks (PNBs) are a type of regional anesthesia in which anesthetic is injected near a specific nerve or bundle of nerves to block pain. These interventions can help patients better manage their postoperative pain, and reduce opioid consumption after surgery. The evidence examining the effectiveness and safety of PNBs in cardiothoracic surgery is fragmented and sometimes conflicting with low or very low quality. An updated clinical understanding of PNBs in cardiothoracic procedures may help inform pain management decisions.

Innovation and Impact

Our goal was to conduct a systematic review that examines the benefits and harms of diverse peripheral nerve blocks for adult cardiothoracic surgical populations. This review will facilitate the American Society of Anesthesiologists’ efforts to update their 2012 clinical practice guideline on acute pain management in the perioperative setting.