Adjunct medications for peripheral and neuraxial anesthesia

Patrick Ifesinachi Emelife¹, Matthew R Eng², Bethany L Menard³, Andrew S Myers⁴, Elyse M Cornett⁵, Richard D Urman⁶, Alan D Kaye⁷

Affiliations

¹ Department of Anesthesiology, LSU Health Sciences Center, Room 653, 1542 Tulane Ave., New Orleans, LA, 70112, USA. Electronic address: pemeli@lsuhsc.edu.
² Department of Anesthesiology, LSU Health Sciences Center, Room 656, 1542 Tulane Ave., New Orleans, LA, 70112, USA. Electronic address: meng@lsuhsc.edu.
³ Department of Anesthesiology, LSU Health Sciences Center, Room 656, 1542 Tulane Ave., New Orleans, LA, 70112, USA. Electronic address: bmenar@lsuhsc.edu.
⁴ LSU Health Sciences Center, 433 Bolivar St., New Orleans, LA, 70112, USA. Electronic address: amyer1@lsushc.edu.
⁵ Department of Anesthesiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA. Electronic address: ecorne@lsuhsc.edu.
⁶ Department of Anesthesiology, Perioperative and Pain Medicine, Harvard Medical School, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA. Electronic address: rurman@bwh.harvard.edu.
⁷ Department of Anesthesiology, LSU Health Sciences Center, Room 653, 1542 Tulane Ave., New Orleans, LA, 70112, USA. Electronic address: akaye@lsuhsc.edu.

PMID: 30322466
DOI: 10.1016/j.bpa.2018.06.011

Review

Adjunct medications for peripheral and neuraxial anesthesia

Patrick Ifesinachi Emelife et al. Best Pract Res Clin Anaesthesiol. 2018 Jun.

. 2018 Jun;32(2):83-99.

doi: 10.1016/j.bpa.2018.06.011. Epub 2018 Jul 3.

Authors

Patrick Ifesinachi Emelife¹, Matthew R Eng², Bethany L Menard³, Andrew S Myers⁴, Elyse M Cornett⁵, Richard D Urman⁶, Alan D Kaye⁷

Affiliations

¹ Department of Anesthesiology, LSU Health Sciences Center, Room 653, 1542 Tulane Ave., New Orleans, LA, 70112, USA. Electronic address: pemeli@lsuhsc.edu.
² Department of Anesthesiology, LSU Health Sciences Center, Room 656, 1542 Tulane Ave., New Orleans, LA, 70112, USA. Electronic address: meng@lsuhsc.edu.
³ Department of Anesthesiology, LSU Health Sciences Center, Room 656, 1542 Tulane Ave., New Orleans, LA, 70112, USA. Electronic address: bmenar@lsuhsc.edu.
⁴ LSU Health Sciences Center, 433 Bolivar St., New Orleans, LA, 70112, USA. Electronic address: amyer1@lsushc.edu.
⁵ Department of Anesthesiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA. Electronic address: ecorne@lsuhsc.edu.
⁶ Department of Anesthesiology, Perioperative and Pain Medicine, Harvard Medical School, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA. Electronic address: rurman@bwh.harvard.edu.
⁷ Department of Anesthesiology, LSU Health Sciences Center, Room 653, 1542 Tulane Ave., New Orleans, LA, 70112, USA. Electronic address: akaye@lsuhsc.edu.

PMID: 30322466
DOI: 10.1016/j.bpa.2018.06.011

Abstract

Regional and neuraxial anesthesia can provide a safer perioperative experience, greater satisfaction, reduced opioid consumption, and reduction of pain, while minimizing side effects. Ultrasound technology has aided clinicians in depositing local anesthetic medication in precise proximity to targeted peripheral nerves. There are a plethora of adjuvants that have been utilized to prolong local anesthetic actions and enhance effects in peripheral nerve blocks. This manuscript describes the current state of the use of adjuncts, e.g., dexmedetomidine, dexamethasone, clonidine, epinephrine, etc., in regional anesthesia. Additionally, evidence behind dosing and block prolongation is summarized along with patient outcomes, adverse effects, and future directions.

Keywords: adjuvant; neuraxial anesthesia; peripheral nerve block; prolongation; regional anesthesia.

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Adjunct medications for peripheral and neuraxial anesthesia

Affiliations

Adjunct medications for peripheral and neuraxial anesthesia

Authors

Affiliations

Abstract

Publication types

MeSH terms

Substances