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Open AccessReview
Integrating Peripheral Nerve Blocks in Multiple Trauma Care: Current Evidence and Clinical Challenges
by
Liliana Mirea
Liliana Mirea 1,2,
Ana-Maria Dumitriu
Ana-Maria Dumitriu 2,*,
Cristian Cobilinschi
Cristian Cobilinschi 1,2
,
Răzvan Ene
Răzvan Ene 1,3 and
Raluca Ungureanu
Raluca Ungureanu 1,2
1
Faculty of Medicine, “Carol-Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
2
Anesthesiology and Intensive Care Clinic, Clinical Emergency Hospital, 050098 Bucharest, Romania
3
Orthopedics and Trauma Surgery, Clinical Emergency Hospital, 050098 Bucharest, Romania
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2025, 14(15), 5598; https://doi.org/10.3390/jcm14155598 (registering DOI)
Submission received: 4 July 2025
/
Revised: 25 July 2025
/
Accepted: 30 July 2025
/
Published: 7 August 2025
Abstract
Pain management in multiple trauma patients presents a complex clinical challenge due to competing priorities such as hemodynamic instability, polypharmacy, coagulopathy, and the urgency of life-saving interventions. In this context, peripheral nerve blocks (PNBs) are increasingly recognized as a valuable asset for their role in managing pain in patients with multiple traumatic injuries. By reducing reliance on systemic opioids, PNBs support effective pain control and facilitate early mobilization, aligning with enhanced recovery principles. This narrative review summarizes current evidence on the use of PNBs in the context of polytrauma, focusing on their analgesic efficacy, integration within multimodal analgesia protocols, and contribution to improved functional outcomes. Despite these advantages, clinical application is limited by specific concerns, including the potential to mask compartment syndrome, the risk of nerve injury or local anesthetic systemic toxicity (LAST), and logistical barriers in acute trauma settings. Emerging directions in the field include the refinement of ultrasound-guided PNB techniques, the expanded use of continuous catheter systems, and the incorporation of fascial plane blocks for anatomically complex or multisite trauma. Parallel efforts are focusing on the development of decision-making algorithms, improved risk stratification tools, and integration into multimodal analgesic pathways. There is also growing emphasis on standardized clinical protocols, simulation-based training, and patient education to enhance safety and consistency in practice. As evidence continues to evolve, the long-term impact of PNBs on functional recovery, quality of life, and healthcare utilization must be further explored. With thoughtful implementation, structured training, and institutional support, PNBs may evolve into a cornerstone of modern trauma analgesia.
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MDPI and ACS Style
Mirea, L.; Dumitriu, A.-M.; Cobilinschi, C.; Ene, R.; Ungureanu, R.
Integrating Peripheral Nerve Blocks in Multiple Trauma Care: Current Evidence and Clinical Challenges. J. Clin. Med. 2025, 14, 5598.
https://doi.org/10.3390/jcm14155598
AMA Style
Mirea L, Dumitriu A-M, Cobilinschi C, Ene R, Ungureanu R.
Integrating Peripheral Nerve Blocks in Multiple Trauma Care: Current Evidence and Clinical Challenges. Journal of Clinical Medicine. 2025; 14(15):5598.
https://doi.org/10.3390/jcm14155598
Chicago/Turabian Style
Mirea, Liliana, Ana-Maria Dumitriu, Cristian Cobilinschi, Răzvan Ene, and Raluca Ungureanu.
2025. "Integrating Peripheral Nerve Blocks in Multiple Trauma Care: Current Evidence and Clinical Challenges" Journal of Clinical Medicine 14, no. 15: 5598.
https://doi.org/10.3390/jcm14155598
APA Style
Mirea, L., Dumitriu, A.-M., Cobilinschi, C., Ene, R., & Ungureanu, R.
(2025). Integrating Peripheral Nerve Blocks in Multiple Trauma Care: Current Evidence and Clinical Challenges. Journal of Clinical Medicine, 14(15), 5598.
https://doi.org/10.3390/jcm14155598
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