# Regional anaesthesia

Regional anaesthesia

Regional anaesthesia involves central neuraxial or peripheral nerve or plexus blocks using local anaesthetic drugs. It has a clear advantage when general anaesthesia carries a higher risk of  morbidity and mortality , such as in patients with debilitating respiratory and cardiovascular disease and obstetric cases. It also provides excellent pain relief  in the postoperative period, reducing the need for analgesics such as opioids. As with general anaesthesia, venous access should be established and vital parameters should be monitored during regional anaesthesia. Localising nerves using anatomical landmarks and eliciting paraesthesia alone carries a high risk of  nerve damage and intravascular injection and has a lower success rate. The use of nerve stimulators to localise nerves impro ves the success rate and reduces risks. Ultrasound-guided regional anaesthesia allows the visualisation of  nerves and the spread of  local anaes thetics, enabling the use of  a smaller dose of  local anaesthetic agents with improved success rates and safety . Summary box 23.8 Types of anaesthesia /uni25CF /uni25CF /uni25CF /uni25CF 

General anaesthesia may be more acceptable to patients
Regional anaesthesia has major advantages in obstetrics and
patients with respiratory compromise
Local blocks have been transformed by nerve stimulators and
ultrasound guidance
All require full resuscitation and monitoring equipment to be
available

Regional anaesthesia

Regional anaesthesia involves central neuraxial or peripheral nerve or plexus blocks using local anaesthetic drugs. It has a clear advantage when general anaesthesia carries a higher risk of  morbidity and mortality , such as in patients with debilitating respiratory and cardiovascular disease and obstetric cases. It also provides excellent pain relief  in the postoperative period, reducing the need for analgesics such as opioids. As with general anaesthesia, venous access should be established and vital parameters should be monitored during regional anaesthesia. Localising nerves using anatomical landmarks and eliciting paraesthesia alone carries a high risk of  nerve damage and intravascular injection and has a lower success rate. The use of nerve stimulators to localise nerves impro ves the success rate and reduces risks. Ultrasound-guided regional anaesthesia allows the visualisation of  nerves and the spread of  local anaes thetics, enabling the use of  a smaller dose of  local anaesthetic agents with improved success rates and safety . Summary box 23.8 Types of anaesthesia /uni25CF /uni25CF /uni25CF /uni25CF 

General anaesthesia may be more acceptable to patients
Regional anaesthesia has major advantages in obstetrics and
patients with respiratory compromise
Local blocks have been transformed by nerve stimulators and
ultrasound guidance
All require full resuscitation and monitoring equipment to be
available

Regional anaesthesia

Regional anaesthesia involves central neuraxial or peripheral nerve or plexus blocks using local anaesthetic drugs. It has a clear advantage when general anaesthesia carries a higher risk of  morbidity and mortality , such as in patients with debilitating respiratory and cardiovascular disease and obstetric cases. It also provides excellent pain relief  in the postoperative period, reducing the need for analgesics such as opioids. As with general anaesthesia, venous access should be established and vital parameters should be monitored during regional anaesthesia. Localising nerves using anatomical landmarks and eliciting paraesthesia alone carries a high risk of  nerve damage and intravascular injection and has a lower success rate. The use of nerve stimulators to localise nerves impro ves the success rate and reduces risks. Ultrasound-guided regional anaesthesia allows the visualisation of  nerves and the spread of  local anaes thetics, enabling the use of  a smaller dose of  local anaesthetic agents with improved success rates and safety . Summary box 23.8 Types of anaesthesia /uni25CF /uni25CF /uni25CF /uni25CF 

General anaesthesia may be more acceptable to patients
Regional anaesthesia has major advantages in obstetrics and
patients with respiratory compromise
Local blocks have been transformed by nerve stimulators and
ultrasound guidance
All require full resuscitation and monitoring equipment to be
available