Peripheral nerve blockade in the treatment of pain

Local anaesthetic blockade of the peripheral nervous system was historically important in the provision of surgical anaesthesia and postoperative analgesia. With increasing awareness of the potential benefits of regional anaesthesia, there has been a resurgence of interest in the role of peripheral nerve blockade in the management of pain. Surgical anaesthesia remains the prime indication for major nerve blocks, but they are now used more frequently to manage both acute and chronic pain. There are no large prospective trials comparing peripheral nerve blocks with either central neural blockade or general anaesthesia in terms bf improved outcome, but developments in peripheral multimodal analgesia, new local anaesthetics and adjuvant drugs offer the potential for greater patient benefit from peripheral nerve blocks in the future.