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Anesthesiology Research and Practice
Volume 2011 (2011), Article ID 124898, 12 pages
http://dx.doi.org/10.1155/2011/124898
Review Article

Perioperative Nerve Blockade: Clues from the Bench

1Pain Center, Department of Anesthesiology, University Hospital Center and University of Lausanne, 1011 Lausanne, Switzerland
2Department of Cell Biology and Morphology, University of Lausanne, 1011 Lausanne, Switzerland
3Pain Research Center and Department of Anesthesiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA

Received 6 January 2011; Revised 23 March 2011; Accepted 6 May 2011

Academic Editor: Gabriella Iohom

Copyright © 2011 M. R. Suter et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Peripheral and neuraxial nerve blockades are widely used in the perioperative period. Their values to diminish acute postoperative pain are established but other important outcomes such as chronic postoperative pain, or newly, cancer recurrence, or infections could also be influenced. The long-term effects of perioperative nerve blockade are still controversial. We will review current knowledge of the effects of blocking peripheral electrical activity in different animal models of pain. We will first go over the mechanisms of pain development and evaluate which types of fibers are activated after an injury. In the light of experimental results, we will propose some hypotheses explaining the mitigated results obtained in clinical studies on chronic postoperative pain. Finally, we will discuss three major disadvantages of the current blockade: the absence of blockade of myelinated fibers, the inappropriate duration of blockade, and the existence of activity-independent mechanisms.