Skip to main content Accessibility help
×
Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-24T18:03:55.209Z Has data issue: false hasContentIssue false

Chapter 18 - Fundamentals of Regional Anaesthesia

Published online by Cambridge University Press:  18 August 2022

Daniel Rodger
Affiliation:
Senior Lecturer in Perioperative Practice, London South Bank University
Kevin Henshaw
Affiliation:
Associate Head of Allied Health Professions, Edge Hill University, Ormskirk
Paul Rawling
Affiliation:
Senior Lecturer in Perioperative Practice, Edge Hill University, Ormskirk
Scott Miller
Affiliation:
Consultant Anaesthetist, St Helens and Knowsley Hospitals NHS Trust
Get access

Summary

Regional anaesthesia is the use of local anaesthetic drugs to block sensations of pain from a large area of the body. It is used to allow surgery to proceed either without general anaesthesia or combined with general anaesthesia to provide superior pain relief than can be achieved with analgesic drugs alone. It is broadly divided into two categories. Neuraxial blocks involve injection of local anaesthetic close to the spinal cord, such as in the subarachnoid (intrathecal) space (known as a spinal) or in the epidural space (known as an epidural). Peripheral nerve blocks involve injection of local anaesthetic near peripheral nerves or plexuses. This can be performed either using landmark technique, a nerve stimulator, or with ultrasound guidance depending on the chosen block. Common equipment and techniques used to perform regional anaesthesia are discussed in this chapter, as well as advantages, potential risks, and the patient preparation and monitoring that is required.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2022

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Wu, C. L., Naqibuddin, M., and Fleisher, L. A.. Measurement of patient satisfaction as an outcome of regional anesthesia and analgesia: a systematic review. Regional Anesthesia and Pain Medicine 2001; 26: 196208.Google Scholar
Gan, T. J., Diemunsch, P., Habib, A., et al. Consensus guidelines for the management of postoperative nausea and vomiting. Anesthesia and Analgesia 2014; 118: 85113.CrossRefGoogle ScholarPubMed
Smith, L. M., Cozowicz, C., Uda, Y., et al. Neuraxial and combined neuraxial/general anesthesia compared to general anesthesia for major truncal and lower limb surgery: a systematic review and meta-analysis. Anesthesia and Analgesia 2017; 125: 19311945.CrossRefGoogle ScholarPubMed
Memtsoudis, S. G., Sun, X., and Chiu, Y. L., et al. Perioperative comparative effectiveness of anesthetic technique in orthopedic patients. Anesthesiology 2013; 118: 10461058.CrossRefGoogle ScholarPubMed
The Association of Anaesthetists. Guidelines for the management of severe local anaesthetic toxicity. Available from: https://anaesthetists.org/Home/Resources-publications/Guidelines/Management-of-severe-local-anaesthetic-toxicity.Google Scholar
Obstetric Anaesthetists Association. Epidural information card. Available from: www.oaa-anaes.ac.uk/assets/_managed/editor/File/Info%20for%20Mothers/EIC/2008_eic_english.pdf.Google Scholar
Campbell, J. P., Plaat, F., Checketts, M. R., et al. Safety guideline: skin antisepsis for central neuraxial blockade. Anaesthesia 2014; 69: 12791286.Google Scholar
Desai, N., Albrecht, E., and El-Boghdadly, K.. Perineural adjuncts for peripheral nerve block. BJA Education 2019; 19: 272282.CrossRefGoogle ScholarPubMed
NHS Improvement. Never events policy and framework, 2018. Available from: www.england.nhs.uk/publication/never-events/.Google Scholar
Regional Anaesthesia United Kingdom. Stop Before you Block. www.ra-uk.org/index.php/stop-before-you-block.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×