Managing Pain on the Battlefield: An Introduction to Continuous Peripheral Nerve Blocks

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.