Principles and Practice of Regional Anaesthesia

Over 100 years after the discovery of the local anaesthetic effects of cocaine there is wide variation in the extent to which regional anaesthesia is practised and taught in the United Kingdom. We hope that this book will give an indication of the scope and potential place of regional anaesthesia in British practice, as well as providing instruction in its use. The word "anaesthesia" is employed advisedly, because most patients wish to be totally unaware of surgery. "Analgesia" has been reserved for the provision of pain control in th epostoperative period. The adjectives "local" and "regional" have been used interchangeably. The successful use of regional anaesthesia requires a thorough knowledge of anatomy and skill in the appropriate technique of needle insertion, but there is much more to the subject. The anaesthetist must be able to determine which patients will and will not benefit. To do this successfully he must understand the effects of the techniques and the ways in which they differ from those of general anaesthesia. He must then choose from the several techniques and drugs available the most suitable for the particular patient and surgical procedure.
Finally he must understand and cater for the needs of the patient during and after the operation itself. The aim of this book is to help the specialist anaesthetist who is unfamiliar with the use of regional anaesthesia. The book is divided into two parts. The first outlines the general principles for safe, effective practice and the second describes anatomy and technique. Some aspects are considered in both sections. The main reason for this is to allow each chapter to stand on its own, but the authors try to avoid extensive repetition.