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Managing Pain on the Battlefield: An Introduction to Continuous Peripheral Nerve Blocks
  1. J G Hunter, Undergraduate Services1
  1. 1Peninsula Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, TR1 3HD +44(0)1752 437444 +44(0)1752 517842 jeremy.hunter{at}students.pcmd.ac.uk

Abstract

Objective To determine the strength of evidence supporting the battlefield use of Continual Peripheral Nerve Blocks (CPNBs).

Methods Publication review identifying 380 potentially relevant papers.

Results CPNBs have been well trialled and are used routinely in civilian hospitals. The procedure is not without acute and chronic complications related to agents used, catheters themselves and infection risks. These techniques are being used increasingly in military field hospitals to manage pain, however research concerning their use on the battlefield is limited and further trials are required to confidently conclude efficacy.

Conclusion CPNBs are just one component within military medicine of a rapidly evolving polymodal system of pain management. Common combat wounds, namely traumatic amputations, are compatible with this technique, however current evidence concerning their battlefield use is limited. Extensive UK military trials are ongoing and the results of which are expected to clarify questions regarding complication rate and efficacy.

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