Regional anaesthesia
Regional anaesthesia refers to using local anaesthetics to render a specific area of the body anesthetised. It is used for operative anaesthesia but also for post-operative analgesia. They don’t cause loss of consciousness, but they may be combined with general anaesthetics to achieve this.
Many adult surgeries can be performed with regional anaesthesia alone, without general anaesthesia. Regional anaesthesia is becoming more and more popular, as they have various advantages compared to general anaesthesia:
- It’s better for elderly
- Cheaper
- There’s no need for airway management, avoiding potential complications
- Less opioids are needed
- Less post-operative nausea and vomiting (PONV)
- Reduced postoperative pain
- Few cardiovascular and pulmonary side effects
Types
There are various types:
- Central regional anaesthesia (neuraxial block) – anaesthesia of the spinal cord
- Epidural anaesthesia
- Subarachnoid (spinal) anaesthesia
- Combined spinal-epidural anaesthesia
- Peripheral regional anaesthesia (nerve block) – anaesthesia of peripheral nerves
- Major (multiple nerves or a plexus)
- Cervical plexus block
- Brachial plexus block
- Interscalene block
- Supraclavicular block
- Infraclavicular block
- Axillary block
- Minor (single nerve)
- Sciatic nerve block
- Femoral nerve block
- Digital nerve block
- Intravenous regional anaesthesia
- Intraarticular anaesthesia
- Major (multiple nerves or a plexus)
- Local anaesthesia
- Infiltration anaesthesia
- Topical anaesthesia
Indications
Regional anaesthesia is preferable in:
- Surgical oncology
- Orthopaedic/traumatological surgery
- C-section
- Lower limb revascularisation
- Obese patients
- Elderly patients (prevents post-operative cognitive dysfunction (POCD)
- Paediatric surgery (in addition to general anaesthesia)