Understanding Anesthesiology - The Global Regional Anesthesia ...

SECTION 1
Anesthetic Techniques
In This Section
1. Local Anesthesia
2. Sedation
3. Regional Anesthesia
4. General Anesthesia
Except in the most desperate of circumstances,
surgical procedures are performed with the benefit
of anesthesia. There are four types of anesthesia
that may be employed alone or in combination:
• local
• sedation (minimal, moderate or deep)
• regional
• general
The findings on pre-operative assessment, the nature
of the surgery and the patient’s preference
all factor into the choice of anesthetic technique.
Contrary to popular belief, studies have failed to
identify one technique as superior (lower morbidity
and mortality) to the others in a general patient
population. Regardless of the technique employed,
the anesthesiologist must ensure patient
comfort, maintenance of physiologic homeostasis
and provision of adequate operating conditions.
Local Anesthesia
Local anesthesia refers to the infiltration of a local
anesthetic agent at the surgical site and is usually
performed by the surgeon. This technique is
appropriate for superficial procedures such as
dental surgery, breast biopsy or carpal tunnel release.
Local anesthesia may be used in an unmonitored
setting. However, often it is used in
combination with sedation in which case monitoring
is required. While local anesthesia is inadequate
for more invasive procedures such as those
involving the body cavities, local infiltration is
often used as an adjunct in post-operative pain
management. Care must be taken to avoid intravascular
injection and to avoid exceeding the
toxic dose of the local anesthetic in use.
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