Regional analgesia for orthopedic surgery

Abstract

With increasing desire for early discharge and even same day surgery, regional anesthesia has taken a central role in multimodal based perioperative patient management. Improvement in equipment, including ultrasound machines, needles and “GPS” like guidance systems has made regional anesthesia safer. Understanding local anesthetic addative satety profiles and use of catheter based techniques has markedly extended pain relief compared to single shot local anesthetic alone. The introduction of pre-procedure check lists has nearly eleminated block errors while periodic revision of anticoagulation guigelines has aided in preventing bleeding complications previously associated with blocks. The introduction of intralipid into modern practice has greatly reduced the devistating effects of local anesthetic systemic toxicity. Finally, where possible, the creation of a block area for pre-procedure blocks facilitates case flow and eleminates delays.