Scribd
Upload
3 views

Principles of Regional Anaesthesia 2

Regional anaesthesia is a technique that involves reversible nerve conduction blockade for effective intraoperative and postoperative analgesia. It includes neuraxial and peripheral nerve blocks, with indications for various surgical procedures and advantages such as reduced opioid use and better analgesia. Key principles include anatomical knowledge, sterile technique, patient selection, and monitoring to ensure safety and minimize complications.

Uploaded by

noorzang107
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
3 views

Principles of Regional Anaesthesia 2

Regional anaesthesia is a technique that involves reversible nerve conduction blockade for effective intraoperative and postoperative analgesia. It includes neuraxial and peripheral nerve blocks, with indications for various surgical procedures and advantages such as reduced opioid use and better analgesia. Key principles include anatomical knowledge, sterile technique, patient selection, and monitoring to ensure safety and minimize complications.

Uploaded by

noorzang107
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
You are on page 1/ 16

Principles of

Regional
Anaesthesia

Presented by:
Nodenla Bhutia (49)
Noorzang Ongmu Tamang (50)
Introduction
• Regional anaesthesia involves
the reversible blockade of
nerve conduction in specific
areas.

• It is a key technique in
modern anaesthetic practice
for intraoperative and
postoperative analgesia.
Classification of Regional Anaesthesia
1. Neuraxial Blocks:
- Spinal Anaesthesia
- Epidural Anaesthesia
- Caudal Anaesthesia
2. Peripheral Nerve Blocks:
- Upper limb blocks: Brachial plexus blocks
(interscalene, supraclavicular, axillary)
- Lower limb blocks: Femoral, sciatic, popliteal
- Truncal blocks: TAP, rectus sheath, paravertebral
Indications and Advantages

1. Surgery of limbs, abdomen, perineum, and

obstetric procedures

2. Better postoperative analgesia

3. Reduced systemic opioid requirement

4. Less respiratory and cardiovascular depression

5. Useful in high-risk patients


Principles of Regional Anaesthesia
Safe regional anaesthesia begins with:

1. Accurate anatomical knowledge of nerve pathways.

2. Use of landmarks, nerve stimulation, or ultrasound for


guidance.

3. Choice of local anaesthetic – based on duration and onset.

4. Sterile technique to avoid infection.

5. Monitoring for toxicity or complications.


Standard of Care During Regional
Anaesthesia

• Preoperative patient selection


• Informed consent
• Appropriate use of equipment and technique
• Monitoring regional anaesthesia practice
• Accurate and meticulous anaesthesia documentation
• Physician-patient communication
• Appropriate and timely postoperative follow-up
Patient Selection
Inappropriate patient selection:
◦ Some patients are not psychologically
suitable for regional anaesthesia.
◦ Patients with severe mental illness.
◦ Neuraxial techniques in hemodynamic
unstable.
◦ Patients with pre-existing neurologic disease.
◦ Patient refusal
Consent
• Potentially serious complications associated regional
anesthesia should be disclosed to patients, including
convulsions and the risk of cardiac toxicity from
systemic injections of local anesthetics, spinal
cord/nerve injury leading to paralysis or neurologic
deficit, pneumothorax, hematoma, infection, cardiac
arrest, and death.
Monitoring Regional Anaesthesia

• Standard ECG and pulse oximetry are essential monitor

• A baseline blood pressure reading should be obtained and once the

regional anaesthesia procedure is complete, the monitors should remain

attached.
• In conscious patients, Et CO2 monitoring may not be used.

• Evidence of regressing blockade and stable vital signs must be present

to fulfil the criteria for discharge.


• Patients receiving local anaesthetic infusions should be visited regularly

by a qualified physician postoperatively.


Documentation
• Detailed documentation of patient consent and the
clinical procedure is very important.
• Open and honest communication with the patient is
essential for providing
god quality patient care.
Physician-Patient Communication

• Patients may report anxiety, and appropriate preoperative

education for the patient can help mitigate this.


• Patients undergoing supraclavicular blocks should be warned

about the risk of pneumothorax.


• Caution patients about the risk of burns (ie, from radiators) if

sensory anaesthesia continues after discharge.


• Warn patients about lying on paralysed extremities for any

length of time or letting them become dependent.


Contraindications
1. Patient refusal
2. Infection at injection site
3. Coagulopathy or bleeding disorders
4. Severe hypovolemia or shock
5. Raised intracranial pressure (for neuraxial
blocks)
Complications
1. Local anaesthetic toxicity (CNS, cardiovascular)
2. Nerve injury
3. Infection or abscess formation
4. Hypotension and bradycardia (especially in
spinal)
5. Post-dural puncture headache
Summary
• Regional anaesthesia offers site-specific nerve
blockade with many clinical benefits.
• Understanding anatomy, techniques, and
safety protocols is crucial.
• Advancements like ultrasound have improved
accuracy and outcomes.
References
• Bailey & Love's Short Practice of Surgery Williams NS, Bulstrode CJK,
O'Connell PR, editors.27th ed Boca Raton: CRC Press; 2018.
• Bhat SR. SRB's Manual of Surgery. 5th ed. New Delhi: Jaypee
Brothers Medical Publishers; 2016.
• Dr. Lalit Mehta's Handbook of Anaesthesia Mehta L. Handbook of
Anaesthesia. 2nd ed. New Delhi: CBS Publishers & Distributors; 2018.
Thank you

You might also like