REGIONAL ANAESTHESIA

History
 Modern local anaesthesia began with the introduction of Cocaine in 1884 by Karl
Koller.
 The term "regional anaesthesia” first used by Harvey Cushing in 1901 to
describe pain relief by nerve block.
 The journal "Regional Anaesthesia " first published in 1976.

Advantages of RA
1. Effects of drug, limited to part of body to be operated on.
2. After-effects, usually less than GA e.g. pulmonary complications.
3. Patients remain conscious.
4. Early feeding is possible.
5. Chance of vomiting and regurgitation are less than GA.

Disadvantages of GA
1. Patients’ non co-operative (sometimes)
2. Patients’ anxiety about the feeling of pain.

Relative indications for RA

 Avoidance of some of the dangers of GA e.g.
1. Difficult intubation
2. Severe respiratory failure
3. Cases where relaxant problems are expected

Relative contraindications for RA

1. Children < 10
2. Uncooperative or restless patient
3. Psychotic patient
4. Long operations when patient may become uncomfortable or restless

MUSFIQUE