Other types of anaesthesia

Question 1

What are peripheral nerve blocks?

Answer 1

Type of regional anaesthesia. Local anaesthetic is injected around specific nerves, causing the area distal to the nerves to be anaesthetised.

Performed under ultrasound guidance.

Question 2

What is central neuraxial anaesthesia?

Answer 2

Also known as spinal anaesthetic or spinal block.

Used in:
* Caesarean sections
* Transurethral resection of the prostate (TURP)
* Hip fracture repairs

Question 3

Where is spinal anaesthetic given?

Answer 3

Local anaesthetic is injected into the CSF, within the subarachnoid space. Only given in lumbar spine to avoid damaging the spinal cord.

L3/4 or L4/5.

Question 4

What is epidural anaesthesia?

Answer 4

Involves inserting a catheter into the epidural space in the lower back, outside the dura mater - separate to the spinal cord and CSF.

Local anaesthetic meds infused through the catheter into the epidural space, where they diffuse to the surrounding tissues and spinal nerve roots.

Question 5

What is epidural anaesthesia commonly used for?

Answer 5

Analgesia in pregnant women in labour.

Post-op after a laparotomy.

Question 6

Commonly used meds for epidural anaesthesia?

Answer 6

Levobupivacaine, with or without fentanyl.

Question 7

Adverse effects of epidural anaesthesia?

Answer 7

• Headache
• Hypotension
• Motor weakness in legs
• Nerve damage (rare)
• Infection, incl meningitis
• Haematoma (may cause spinal cord compression)

When used for analgesia in labour:
* Prolonged second stage
* Increased probability of instrumental delivery

Question 8

Common medication used in local anaesthesia?

Answer 8

Lidocaine

For smaller operations and procedures.