Orthopaedic Suergery

Spinal anaesthesia is appropriate for shorter procedures, whereas general anaesthesia in combination with a regional technique is generally used for procedures over two hours. Ankle block and sciatic nerve block at the
knee provide effective perioperative analgesia and both are described in detail.
Anaesthesia for Foot and Ankle Surgery – June 1, 2008

This article will detail the factors that determine how local anaesthetic spreads within the CSF, therefore determining the extent of the block.Spinal Anaesthetic Spread – December 1, 2007

Spinal anaesthesia has the advantage that profound nerve block can be produced in a large part of the body by the relatively simple injection of a small amount of local anaesthetic. In the following article the factors that influence how the local anaesthetic spreads within the CSF, determining the extent of the block, are discussed. Spinal Anaesthesia – Assessment of Block – June 1, 2007

There is no single standard anaesthetic technique for hip replacement. An anaesthetic plan should be formulated that will optimally accommodate all aspects of the patient and planned surgical procedure (primary THR versus complex revision THR). Most patients presenting for hip surgery are elderly, and somewhat frail. A thorough preoperative assessment is necessary, but indiscriminate cancellation or delay is inappropriate.Hip Replacement – Anaesthetic Management – June 1, 2004

The administration of intravenous local anaesthetic in an isolated limb by means of an ischaemic cuff is a simple and effective technique, with a low incidence of failure and high degree of safety. Intravenous Regonal Anaesthesia – Bier’s Block – December 1, 2002

Epidural anaesthesia is a central neuraxial block technique with many applications. Improvements in equipment, drugs and technique have made it a popular and versatile anaesthetic technique, with applications in surgery, obstetrics and pain control. Its versatility means it can be used as an anaesthetic, as an analgesic adjuvant to general anaesthesia, and for postoperative analgesia in procedures involving the lower limbs, perineum, pelvis, abdomen and thorax. Epidural Anaesthesia – June 1, 2001

Spinal anaesthesia is induced by injecting small amounts of local anaesthetic into the cerebro-spinal fluid (CSF). The injection is usually made in the lumbar spine below the level at which the spinal cord ends (L2). Spinal anaesthesia is easy to perform and has the potential to provide excellent operating conditions for surgery below the umbilicus. Spinal Anaesthesia – a Practical Guide – December 1, 2000

Regional blocks at the wrist are easy to perform and are useful for a number of situations, such as supplementing arm blocks and Bier’s blocks, minor surgery or dressings on the hand and fingers, repairing hand trauma, pain relief – for example burns to the hand or fingers.Regional Blocks at the Wrist – December 1, 2000

The purpose of this article is to provide a detailed, step by step description of how to safely and reliably perform nerve blocks for surgery and pain relief on the lower limb, for
the non-specialist anaesthetic practitioner. It covers femoral nerve blockade, lumbar plexus blockade using the inguinal paravascular approach and sciatic nerve blockade. No description is given of more distal blocks, since the majority of the limb is readily anaesthetised with the techniques described and as a group they are relatively simple, reliable and commonly used.
Nerve Blocks for Anaesthesia and Analgesia of the Lower Limb – June 1, 2000

The ankle block is a safe and effective method for obtaining anaesthesia and analgesia of the foot for surgical procedures on bones and soft tissues.Ankle Blocks – June 1, 1999

Interscalene block is the most proximal approach to the brachial plexus and is the most suitable block for proximal procedures on the arm or shoulder. The block is a paravertebral approach at the level of the cervical roots in the neck and can provide both brachial and cervical nerve blocks. The areas supplied by C8 and T1 nerve roots may prove difficult to block and this approach is therefore less suitable for surgery on the hand. Supplementary block of the ulnar nerve can provide the necessary analgesia for hand surgery.Interscalene Brachial Plexus Block – December 1, 1998

An axillary block is the most commonly performed variety of brachial plexus block. The landmarks are easy to identify and it is associated with fewer complications than other approaches to the brachial plexus. The technique may be used to provide anaesthesia for a variety of surgical procedures on the hand and forearm. Although in some patients the block may extend above the elbow it does not do this reliably.Axillary Brachial Plexus Block – June 1, 1995

Regional anaesthesia, although popular in certain centres in developing countries, is generally poorly accepted in these areas as a reliable, economical means for providing operative anaesthesia. Failure of single-injection spinal anaesthetic techniques to achieve richly deserved popularity is difficult to understand given the obvious advantages with which such simple, straightforward, effective, safe and even inexpensive techniques are associated.Spinal Anaesthesia in Developing Countries – December 1, 1993