REGIONAL ANAESTHESIA RECENT ADVANCES
By Dr Ammar Salti, Consultant Anaesthesia and Medicine, Zayed Military Hospital, Abu Dhabi, UAE
I
n recent years there has been a growing interest in the practice of regional anaesthesia and, in particular, peripheral
nerve blocks for surgical anaesthesia and postoperative analgesia. Peripheral nerve blocks have been found to be superior to general anaesthesia as they provide effective analgesia with few side effects and can hasten patient recovery. Unfortunately, the practice of regional anaesthesia does not enjoy widespread endorsement because of inconsistent success, varying from one anesthesiologist to another. Current methods of nerve localization (eg, nerve stimulation) are essentially ‘blind’ procedures, since they both rely on indirect evidence of needle-to-nerve contact. Seeking nerves by trial and error and random needle movement can cause
Seeking nerves by trial and error and random needle movement can cause complications
complications. Although uncommon, complications such as intravascular local anesthetic injection resulting in systemic toxicity, inadvertent spinal cord injury following interscalene block, pneumothorax following supraclavicular block, and nerve injury have all been reported. Imaging guidance for nerve localization holds the promise of improving block success and decreasing complications. Among imaging modalities currently available, ultrasonography seems to be the one most suitable for regional anaesthesia. Perhaps the most significant advantage of ultrasound technology is the ability to provide anatomic examination of the area of interest in real-time. Ultrasound imaging
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