Regional anaesthesia for limb surgery: a review of anaesthetists’ beliefs and practice in the Oxford region*

Abstract

Summary We conducted a postal survey of 210 anaesthetists in the Oxford region to determine their views and practice regarding the timing of regional anaesthesia when combined with general anaesthesia for adults undergoing limb surgery and to compare the results with those obtained in a similar survey conducted in 2001. Of the 151 respondents (72% response rate), 102 (68%) regularly combined regional and general anaesthesia for adult limb surgery. Over 80% believed that central neuraxial blocks should be performed before general anaesthesia. This matched their current practice, marking a change from 2001. Significantly fewer anaesthetists believed it necessary to perform peripheral nerve blocks before general anaesthesia than in 2001, marking another significant change in practice. Overall, the results indicate an increased popularity of regional blocks in combination with general anaesthesia when compared with 2001 practice, which we believe is related to high quality advanced training modules now on offer to senior trainees in the Oxford region.

Ultrasound guided thoracic paravertebral block in breast surgery

“…There was a clear difference of opinion in the perceived risks when performing central neuraxial blocks compared with lower limb blocks under general anaesthesia. Our results for the timing of central neuraxial blocks and lower limb blocks are similar to those of the Oxford region survey [4]. Linklater and Chambers report two cases of persistence of analgesia following cessation of epidural infusion administered for the relief of malignant pain [1].…”

Adductor canal block versus femoral nerve block combined with sciatic nerve block as an anesthetic technique for hindfoot and ankle surgery

“…[1,2] Most foot and ankle operations are performed on an outpatient basis, often under some form of regional anesthesia. The use of this type of anesthesia is supported by successful outcomes reported in the literature.…”

Anatomy and Pathophysiology of Spinal Cord Injury Associated With Regional Anesthesia and Pain Medicine

“…Indeed, this topic is an outstanding example of how individuals of similar expertise can arrive at different recommendations after review of the same, albeit limited, data set. For example, some European experts endorse (particularly peripheral) regional blockade in anesthetized or deeply sedated patients, 159,160 whereas the majority of North American experts advise against this practice in adult patients.…”