Review Article
The Role of Epidural Anesthesia Plus Ultrasound-Guided Peripheral Nerve Block and Naldebain in Chronic Post-Surgical Pain
Volume 28,Issue 1,Pages 22-29
Yu-Ping Feng1 , Nian-Cih Huang2 , Hsiao-Jane Chang1 , Chih-Shung Wong1.2.3

1Department of Anesthesiology, Cathay General Hospital, Taipei, Taiwan

2Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan

3Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan



Chronic post-surgical pain (CPSP) is a chronic pain condition that reduces quality of life. The mechanisms of CPSP are complex, and pain management is limited. In particular, perioperative pain management is crucial to ensure long-term pain relief and CPSP prevention. The management and prevention of CPSP involves pharmacological treatment with opioids, acetaminophen, N-methyl-D-aspartate receptor antagonists, anticonvulsants, and local anesthesia. These treatments may be delivered via various routes, but all can provide better postoperative analgesia, with opioid-sparing effects and fewer opioid-related adverse effects, thus, preventing CPSP. Recently, ultrasound-guided peripheral nerve blocks have been widely used for regional anesthesia and postoperative analgesia. A newly lunched continuously released opioid naldebain can provide a long-term perioperative preventive pain inhibition. The present issue of the Taiwan Journal of Pain (TJP), a case report involving the use of ultrasound-guided peripheral nerve block and epidural anesthesia, this combination provided satisfactory anesthesia and postoperative pain relief. Continuous preventive perioperative analgesia is crucial for improving the quality of postoperative pain management, thus, attenuating or even preventing CPSP. This review discusses the role of combination of epidural anesthesia, ultrasound-guided peripheral nerve block plus naldebain in CPSP.

Key Words

Chronic post-surgical pain,Epidural anaesthesia,Nadebain,Ulrasound-giuded nerve block.

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