1. Regional AnesthesiaRegional Anesthesia
Amina Adel Al-QaysiAmina Adel Al-Qaysi
RAK Medical & Health SciencesRAK Medical & Health Sciences
UniversityUniversity

2. DefinitionDefinition
Any technique to induce the absence of
sensation in part of the body

3. Why Regional Anaesthesia?Why Regional Anaesthesia?
• Cheap
• High Patient Satisfaction
• Maintain Patent Airway
• Decreased Blood Loss
• Selective Muscle Relaxation
• Decreased Incidence
of DVT & PE

4. Why Not Regional AnaesthesiaWhy Not Regional Anaesthesia
• Hypotension
• Risk of toxicity
• Many patients prefer to be asleep
• Skills are required
• Patient Can Talk
• Patient Anxiety
• Not Reliable for Surgery > 2 hours

5. Regional anesthesia - TypesRegional anesthesia - Types
• Topical
• Intravenous (Bier’s) block
• Peripheral nerve block
• Plexus: brachial, lumbar
• Neuro-axial block

6. Regional anesthesia - UsesRegional anesthesia - Uses
• Provide anesthesia for a surgical
procedure.
• Provide analgesia post-operatively or
during labor and delivery.
• Therapy for patients with chronic pain
syndromes, cancer.

7. Spread of Local AnaesthesiaSpread of Local Anaesthesia
• Baricity of Local Anaesthetic
• Concentration of Local Anaesthetic
• Position of Patient
• Volume Injected
• Level of Injection
• Speed of Injection

8. Neuro-axial BlockNeuro-axial Block
• Spinal block
• Epidural block
• Caudal block

9. Spinal & EpiduralSpinal & Epidural
AnaesthesiaAnaesthesia
• Local anesthetic injected into the
subarachnoid or epidural space.
• Patient’s position: Sitting, Lateral.
• Approach: Midline, Para-median
• Heavy Marcaine

10. Pre-Procedure PreparationPre-Procedure Preparation
• Patient’s assessment
• Explain the procedure & Obtain consent
• Patient is fasting
• Equipments for resuscitation & GA
• IV line insertion & start fluid load
• Ensure the asepsis.

15. Absolute ContraindicationsAbsolute Contraindications
• Patient’s refusal
• Coagulopathy
• Skin infection at site of insertion
• Increased ICP
• Hypovolemia

16. Relative ContraindicationsRelative Contraindications
• Uncooperative patient.
• Pre-existing neurological disorder.
• Fixed cardiac output states (AS, MS,
HOCM, 3rd
degree heart block).
• Anatomic abnormalities.
• Prophylactic low dose heparin use.

17. Complications of EpiduralComplications of Epidural
AnesthesiaAnesthesia
• Anaphylaxis
• Pain
• Post-spinal headache
• Hypotension & Bradycardia
• Hypothermia
• Nerve damage
• Respiratory failure
• Epidural or intra-thecal bleed
• Spinal cord hematoma
• Infection
• Urinary retention