What specialist performs perineural injections?

From the Guidelines

Perineural injections are typically performed by anesthesiologists, as they have the most recent and highest quality evidence supporting their expertise in this area 1. When considering the management of postoperative pain, particularly in non-traumatic emergency general surgery, the use of perineural injections is a crucial aspect of treatment.

• The most effective perineural injections are those that target specific nerves, such as the rectus sheath block and the transversus abdominis plane (TAP) block, which have been shown to be safe and effective in treating postoperative pain 1.
• These blocks can be performed by various specialists, including pain management specialists, physiatrists, and interventional radiologists, but anesthesiologists are often the primary providers of these services due to their extensive training in regional anesthesia techniques.
• The use of adjuvants, such as perineural dexamethasone with ropivacaine, has also been shown to improve postoperative analgesia quality, highlighting the importance of proper medication selection in perineural injections 1.
• Ultimately, the choice of specialist for perineural injections depends on the specific condition being treated, the location of the injection, and the provider's experience with the particular technique, but anesthesiologists are generally the preferred specialists for these procedures due to their expertise and the high-quality evidence supporting their use of perineural injections 1.

From the Research

Perineural Injections Specialist

• Perineural injections are typically administered by specialists in the field of pain management, including:
  • Anesthesiologists 2
  • Pain management specialists 3
  • Interventional pain physicians 3
• These specialists may work in various settings, such as hospitals, clinics, or private practices, and may use different techniques and modalities to administer perineural injections, including:
  • Landmark-guided injections 3
  • Ultrasound-guided injections 4, 3
  • Radiology-aided injections 3

Types of Perineural Injections

• Perineural injections may involve the use of different substances, including:
  • Local anesthetics 5, 6, 2
  • Steroids 5, 6, 4, 3
  • Corticosteroids 3
• The choice of substance and technique may depend on the specific condition being treated, as well as the patient's individual needs and medical history.

Conditions Treated with Perineural Injections

• Perineural injections may be used to treat a variety of conditions, including:
  • Chronic postoperative inguinal pain 4
  • Peripheral neuropathic pain 5, 6
  • Trauma- or compression-related peripheral neuropathic pain 5, 6
  • Cluster headaches 3
  • Postherniorrhaphy pain 3