Regional anaesthesia for orthopaedic procedures

Regional anaesthesia is well suited to orthopaedic surgery for anatomical reasons and can reduce complications from general anaesthesia. A reduction in pain scores, drowsiness and nausea can improve postoperative mobility and facilitate earlier hospital discharge. Disadvantages to regional anaesthesia include block failure, nerve injury and local anaesthetic toxicity. Complications are rare but can be reduced by the use of ultrasound and nerve stimulation, performing the block on a conscious patient and stopping injection if there is pain or high resistance. Patients should be assessed preoperatively to rule out contraindications such as local infection or coagulopathy, and clear explanations of the procedure and any possible complications should be given. Patients should be seen postoperatively and any suspicious findings should be investigated promptly and followed up until there is complete resolution of symptoms.