Other Specialties

The thoracic paravertebral block was first described in the treatment of chronic pain. More recently, the technique has also been used to provide surgical analgesia for a variety of applications, including thoracic, breast, and general surgery. It is possible to provide analgesia lasting into the postoperative period, and certain procedures may be performed without the need for general anaesthesia.Thoracic Paravertebral Block – June 1, 2009

This article describes the steps taken to evaluate patients’ fitness for lung resection surgery. Examples are used to demonstrate interpretation of these tests. It is vital to use these tests in conjunction with a thorough history and examination in order to achieve an accurate assessment of each patient’s level of function.Pulmonary Function Tests and Lung Resection – June 1, 2009

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

Anaesthesia for neurosurgical procedures requires understanding of the normal anatomy and physiology of the central nervous system and the likely changes that occur in response to the presence of space occupying lesions, trauma or infection.An Introduction to Anaesthesia for Neurosurgery – 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

In sub-Tenon’s block, local anaesthetic agent is injected under the Tenon’s capsule. This block is also known as parabulbar block, pinpoint anaesthesia and medial episcleral block. A thorough knowledge of the anatomy of the orbit is a pre-requisite before embarking on a sub-Tenon’s block.Sub-Tenon’s Block – June 1, 2007

One lung ventilation (OLV) is the term used in thoracic anaesthesia to describe the ability to ventilate one of a patient’s lungs, allowing the other one to collapse. This article will describe indications for OLV, techniques used to achieve OLV, the physiological changes associated with OLV and ways that oxygenation can be improved during OLV.One Lung Ventilation – June 1, 2006

Core operations are lobar resection, pneumonectomy for malignant and non-malignant conditions, mediastinoscopy and mediastinotomy, bronchoscopy for diagnostic and interventional reasons, video-assisted thoracoscopic surgery (VATS) for drainage and investigation of effusions, management of air-leaks, management of empyema and operations on the chest wall. Lung volume reduction surgery and lung transplantation are specialised procedures usually rationalised to specific units or surgeons.Thoracic Anaesthesia Update – June 1, 2004

Circumcision is a common procedure which can be carried out under local anaesthetic. The block is simple to perform and surgery causes little patient distress and has few complications.Circumcision under Local Anaesthetic – June 1, 2004

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

Correction of strabismus is the most commonly performed paediatric ophthalmic operation. Strabismus surgery is normally carried out under general anaesthetic (always so in children), although a local anaesthetic technique may occasionally be used in adults.Anaesthesia for Correction of Strabismus – December 1, 2003

Ophthalmic surgery can be performed under either regional or general anaesthesia. This article describes regional anaesthesia. In the article general anaesthesia will be discussed.Anaesthesia for Eye Surgery – Regional Techniques – June 1, 2003

TURP is a cystoscopic procedure used to alleviate the symptoms of bladder outflow obstruction, usually caused by benign prostatic hypertrophy (BPH). BPH affects 50% of males at 60 years and 90% of 85-year-olds and so TURP is most commonly performed on elderly patients, a population group with a high incidence of cardiac, respiratory and renal disease. The mortality rate associated with TURP is 0.2-6%, with the commonest cause of death being myocardial infarction. Safe anaesthesia depends on the detection and optimisation of co-existing diseases, and on weighing up the relative risks and benefits of regional and general anaesthesia for each patient.Anaesthesia for TURP – June 1, 2003

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

Local anaesthesia is currently performed for many ophthalmic procedures as it is associated with reduced morbidity and mortality when compared with general anaesthesia. Additional benefits include early patient mobilisation, improved patient satisfaction and reduced hospital stay.Topical Anaesthesia for Eye Surgery – December 1, 2000

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

Anaesthesia for emergency eye surgery can present special problems to the anaesthetist. This article discusses the specific problems of emergency anaesthesia for eye surgery. We try and answer the common questions concerning these patients and provide a practical guide.Anaesthesia for Emergency Eye Surgery – June 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

Caudal anaesthesia has been used for many years and is the easiest and safest approach to the epidural space. When correctly performed there is little danger of either the spinal cord or dura being damaged. It is used to provide peri- and postoperative analgesia in adults and children. It may be the sole anaesthetic for some procedures, or it may be combined with general anaesthesia.Caudal Epidural Anaesthesia – June 1, 1998

Surgery on the eye can be performed under either local or general anaesthesia. In the previous issue of Update techniques for local anaesthesia were described. In this article the principles of general anaesthesia for eye surgery are outlined.Anaesthesia for Eye Surgery – General Anaesthesia – June 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

Penile block has been widely used for circumcision. Complications include inadequate block or, rarely, ischaemia. Techniques vary from injection below the symphysis pubis to ring block of the shaft.Penile Block – June 1, 1993