Regional Anaesthesia - Peripheral Nerve Blocks

Question 1

Method of Peripheral Nerve Blocks (2).

Answer 1

1. Inject LA around specific nerves - distal area is anaesthetised.
2. Injection under US guidance and sometimes with Nerve Stimulator.

Question 2

Method of Central Neuraxial Anaesthesia (Spinal Block) (3).

Answer 2

1. Uses : C-Sections, TURPs, Hip Fractures.
2. LA injected into CSF within Sub-Arachnoid Space (only in Lumbar Spine around L3/4 or L4/5 to avoid Spinal Cord Damage).
3. Numbness and Paralysis of areas innervated by spinal nerves below level of injection and test with cold spray (1-3 hours).

Question 3

Method of Epidural Anaesthesia (4).

Answer 3

1. Method : Insert a catheter into Epidural Space in Lower Back, outside Dura Mater (separate from spinal cord and CSF).
2. Infuse LA medications through catheter into epidural space - they will diffuse to surrounding tissues and spinal nerve roots.
3. Common : Levobupivacaine + Fentanyl.
4. Uses : Pregnancy (Labour) and Laparotomy (Post-Operative).