Role of peripheral nerve block in pain control for the management of acute traumatic orthopaedic injuries in the emergency department: Diagnosis-based treatment guidelines

Trauma remains one of the largest problems that the global healthcare system faces today. In the United States it remains the leading cause of death for young and middle-aged patients, and its economic burden in direct cost and loss of productivity is tremendous. Additionally, the challenge of acute pain control in orthopaedic trauma remains substantial, and the over-reliance on opioid medications has resulted in unintended acute and chronic complications and problems. Alternative pain control strategies, such as peripheral nerve block (PNB), have the potential to decrease healthcare cost, opioid consumption, and other opioid-related complications. The purpose of this review is to summarize the current state of pain control and opioid use in acute orthopaedic injury and provide an understanding of the role of PNB to improve pain management. Finally, this review provides a specific diagnosis-based treatment guideline for the use of PNB in acute orthopaedic injury.