Regional anaesthesia
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2008-06-05T05:40:59Z
EricV89
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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]]
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[[Category:Regional anesthesia|*]]
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[[de:Regionalanästhesie]]
[[hu:Regionális érzéstelenítés]]
[[pl:Znieczulenie regionalne]]