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Fascial plane blocks: a narrative review of the literature

Journal

REGIONAL ANESTHESIA AND PAIN MEDICINE
Volume 46, Issue 7, Pages 600-617

Publisher

BMJ PUBLISHING GROUP
DOI: 10.1136/rapm-2020-101909

Keywords

lower extremity; nerve block; anesthesia; local; pain; postoperative; pain management

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This article discusses the concepts and potential mechanisms of fascial plane blocks (FPBs), as well as the major FPBs of the extremities, posterior torso, and anterior torso. It includes characteristics, indications, and a brief summary of the literature on these blocks, with an estimate of the overall level of evidence supporting individual approaches as FPBs continue to rapidly evolve.
Fascial plane blocks (FPBs) are increasingly numerous and are often touted as effective solutions to many perioperative challenges facing anesthesiologists. As 'new' FPBs are being described, questions regarding their effectiveness remain unanswered as appropriate studies are lacking and publications are often limited to case discussions or technical reports. It is often unclear if newly named FPBs truly represent a novel intervention with new indications, or if these new publications describe mere ultrasound facilitated modifications of existing techniques. Here, we present broad concepts and potential mechanisms of FPB. In addition, we discuss major FPBs of (1) the extremities (2) the posterior torso and (3) the anterior torso. The characteristics, indications and a brief summary of the literature on these blocks is included. Finally, we provide an estimate of the overall level of evidence currently supporting individual approaches as FPBs continue to rapidly evolve.

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