Regional anaesthesia 639409 217246953 2008-06-05T05:40:59Z EricV89 1475928 Incorrect spelling (Re: Article's title displays specified spelling) '''Regional anaesthesia''', is [[anesthesia]] affecting only a large part of the body, such as a limb. Regional anaesthetic techniques can be divided into central and peripheral techniques. The central techniques include so called neuroaxial blocks ([[epidural]] anaesthesia, [[spinal anaesthesia]]). The peripheral techniques can be further divided into plexus blocks such as [[brachial plexus block]]s, and single nerve blocks. Regional anesthesia may be performed as a single shot or with a continuous catheter through which medication is given over a prolonged period of time, e.g [[CPNB|continuous peripheral nerve block]]. Last but not least, regional anesthesia can be provided by injecting local anesthetics directly into the veins of an arm (provided the venous flow is impeded by a tourniquette.) This is called intravenous regional techniques ([[Bier block]]). Regional anaesthesia generally involves the introduction of [[local anaesthetic]]s to block the [[nerve]] supply to a specific part of the body, such as a limb, so patients cannot feel [[pain]]. ''Note:'' The following terms are often used interchangeably: * ''[[Local anesthesia]]'', in a strict sense, is [[anesthesia]] of a small part of the body such as a tooth or an area of skin. * ''Regional anesthesia'' is aimed at anesthetizing a larger part of the body such as a leg or arm. * ''Conduction anesthesia'' is a comprehensive term which encompasses a great variety of local and regional anesthetic techniques. ==Indications and applications== Regional anaesthesia may provide anaesthesia (absence of pain) to allow a [[surgical operation]], or provide post-operative pain relief. Various [[brachial plexus block]]s exist for [[shoulder]] and [[arm]] procedures. Methods similar to routine regional anaesthetic techniques are also often used for treating chronic pain. In labour and [[childbirth]], epidural or combined spinal epidurals provide effective pain relief. Regional anaesthesia is now more common than general anaesthesia for [[caesarian section]] procedures. Nerve blocks are widely used in [[veterinary medicine]] to diagnose lameness. A very common application is the diagnosis of [[navicular disease]] in [[horse]]s. == Relationship to other anaesthetic techniques== Unlike [[general anaesthesia]], patients may remain awake during the procedure, resulting in reduced [[Adverse effect (medicine)|side-effects]] and enabling the surgeon to converse with the patient during the procedure if required. However, many patients prefer to receive [[sedation]] either during the block, the procedure, or both. There is a spectrum of complexity between simple local anaesthetic infiltration and major regional blocks, such as the 'central neuraxial blocks' (spinal and epidural), with nerve blocks lying in the middle. [[Nerve block]]s affecting major peripheral nerves such as the [[femoral nerve]] and [[sciatic nerve]] are also sometimes viewed as regional anaesthetic techniques. ==Complications== Unlike a minor local anaesthetic infiltration to allow a wound to be sutured, or a skin lesion to be excised, regional anaesthesia may involve large doses of [[local anaesthetic]], or administration of the local anaesthetic very close to, or directly into the central nervous system. Therefore there is a risk of complications from local anaesthetic toxicity (such as seizures and cardiac arrest) and for a syndrome similar to [[spinal shock]]. Most regional anaesthetic techniques, even in expert hands, have a failure rate of 1-10%. Therefore general anaesthesia may become necessary even when a procedure was initial planned to be conducted under a regional technique. For these reasons, regional anaesthesia is only ever conducted in an environment that is fully equipped and staffed to provide safe general anaesthesia should this be needed. ==See also== * [[Nerve block]] * [[Local anaesthesia]] {{pain}} [[Category:Regional anesthesia|*]] {{med-stub}} [[de:Regionalanästhesie]] [[hu:Regionális érzéstelenítés]] [[pl:Znieczulenie regionalne]]