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Chapter 18 - Fundamentals of Regional Anaesthesia

Published online by Cambridge University Press:  18 August 2022

By
Will Angus  and
Karim Mukhtar
Edited by
Daniel Rodger ,
Kevin Henshaw ,
Paul Rawling  and
Scott Miller
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
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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.

Keywords

RegionalSpinalEpiduralCaudalBlockUltrasoundAnalgesiaAnaesthesia
Type
Chapter
Information
Fundamentals of Operating Department Practice , pp. 191 - 203
Publisher: Cambridge University Press
Print publication year: 2022

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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: 196–208.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: 85–113.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: 1931–1945.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: 1046–1058.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: 1279–1286.Google Scholar
Desai, N., Albrecht, E., and El-Boghdadly, K.. Perineural adjuncts for peripheral nerve block. BJA Education 2019; 19: 272–282.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

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