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Central regional anaesthesia: Difference between revisions
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(Created page with "'''Central regional anaesthesia''', also called '''neuraxial block''', refers to either epidural or subarachnoid anaesthesia, forms of regional anaesthesia. Both types may cause haemodynamic changes, especially hypotension, due to blockade of the sympathetic fibres. == Epidural anaesthesia == Epidural anaesthesia involves injection of local anaesthetic with or without opioids into the epidural space to act on spinal nerve roots. Nerve roots around the site o...") |
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'''Central regional anaesthesia''', also called '''neuraxial block''', refers to either epidural or subarachnoid anaesthesia, forms of [[regional anaesthesia]]. Both types may cause haemodynamic changes, especially [[hypotension]], due to blockade of the sympathetic fibres. | '''Central regional anaesthesia''', also called '''neuraxial block''', refers to either epidural or subarachnoid anaesthesia, forms of [[regional anaesthesia]]. Both types may cause haemodynamic changes, especially [[hypotension]], due to blockade of the sympathetic fibres. | ||
== Indications == | |||
Regional anaesthesia is preferable (compared to general anaesthesia) in: | |||
*[[Surgical oncology]] | |||
*Orthopaedic/traumatological surgery | |||
*[[C-section]] | |||
*Lower limb revascularisation | |||
*[[Obesity|Obese patients]] | |||
*Elderly patients (prevents post-operative cognitive dysfunction (POCD) | |||
*Paediatric surgery (in addition to [[general anaesthesia]]) | |||
== Epidural anaesthesia == | == Epidural anaesthesia == | ||
Epidural anaesthesia involves injection of [[local anaesthetic]] with or without opioids into the epidural space to act on spinal nerve roots. Nerve roots around the site of injection are affected, while leaving the nerve roots above and below mostly unaffected. Epidural anaesthesia may be administered at any vertebral level. The drugs are administered via a catheter for continuous infusion. | Epidural anaesthesia involves injection of [[local anaesthetic]] with or without opioids into the epidural space to act on spinal nerve roots. Nerve roots around the site of injection are affected, while leaving the nerve roots above and below mostly unaffected. Epidural anaesthesia may be administered at any vertebral level. The drugs are administered via a catheter for continuous infusion. | ||
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Spinal anaesthesia may only be placed in the lumbar region. It has more rapid onset than epidural, but also causes more rapid haemodynamic changes than epidural. Like epidural anaesthesia, it is often used for surgeries of the lower body, below the level of the umbilicus. | Spinal anaesthesia may only be placed in the lumbar region. It has more rapid onset than epidural, but also causes more rapid haemodynamic changes than epidural. Like epidural anaesthesia, it is often used for surgeries of the lower body, below the level of the umbilicus. | ||
Epidural and spinal anaesthesia may be combined, called combined spinal-epidural anaesthesia (CSE).<noinclude>[[Category:Anaesthesiology]] | Epidural and spinal anaesthesia may be combined, called combined spinal-epidural anaesthesia (CSE).<noinclude> | ||
[[Category:General surgery]]</noinclude> | [[Category:Anaesthesiology]] | ||
[[Category:General surgery]] | |||
</noinclude> | |||