Local Anesthetic Block

The indications for local anesthetic nerve blocks have been categorized by Bonica into:

• prophylactic;

The practical value of this classification is as relevant to pain in neurological disease as in any other clinical context. The indications for, and practical use of, peripheral nerve blocks is discussed in Chapter 23, Peripheral nerve blocks: practical aspects in the Practice and Procedures volume of this series. It now seems clear that serial local anesthetic blocks - with or without the addition of corticosteroid - may provide extended periods of relief of chronic pain, long outlasting the anticipated direct duration of action of the local anesthetic drug.59[V] More studies are needed to establish the indications and general utility of this form of treatment for pain in various neurologic disorders. The role, if any, of steroids is not established.

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