Extending the Duration of Your Peripheral Nerve Block: From Perineural Additives and Continuous Catheters, to Liposomal Preparations and Beyond.

Pain is a common event after surgery and impacts a patient's satisfaction, quality of life, and recovery. Single-injection nerve blocks provide effective analgesia but are limited to 6 to 10 hours, often resulting in rebound pain. Strategies to prolong analgesia include continuous nerve catheters, perineural adjuncts (dexamethasone, dexmedetomidine, buprenorphine, clonidine, and epinephrine), and liposomal bupivacaine. Continuous nerve catheters remain the most effective but require technical expertise. Emerging options such as peripheral nerve stimulation show promise in reducing postoperative pain and opioid reliance. Further research is needed to optimize safety and efficacy.