Neuraxial versus Peripheral Nerve Block for Post-operative Pain Management in Drug Abusers Undergoing Emergency Orthopaedic Surgeries

Abstract

When a noxious stimulus produces tissue injury, chemical mediators are released and activate nociceptors which in turn generate nerve impulses. Uncontrolled postoperative pain has an adverse sequel of delayed resumption of normal pulmonary function, restriction of mobility, nausea and vomiting, increase in the systemic vascular resistance, cardiac work, and myocardial oxygen consumption through an increase in the catecholamine release induced by the stress response. Orthopedic surgeries are associated with moderate to severe postoperative pain, so these procedures are better to be done under regional anesthetic techniques which reduce neuro-endocrinal stress responses, central sensitization of the nervous system and muscle spasms which occur in response to painful stimuli.