Local Anesthetic Adjuvants Providing the Longest Duration of Analgesia for Single Injection Peripheral Nerve Blocks in Orthopedic Surgery: A Systematic Review

Abstract

Inadequate pain relief after surgery may delay surgical recovery, decrease patient satisfaction, increase length of stay, increase hospital readmissions, and increase overall health care costs. One way to decrease postoperative pain for patients undergoing orthopedic surgery is through utilization of peripheral nerve blocks. There are many adjuvants anesthesia providers can add to local anesthetics to improve the quality and prolong the duration of analgesia. The purpose of this literature review is to evaluate different local anesthetic adjuvants that prolong the duration of single-injection peripheral nerve blocks. A systematic review of studies using PubMed, MEDLINE, and Cochrane databases was performed using predefined data fields. Based on this literature review, recommendations for practice are provided.