Regional Anaesthesia and Outcomes

Any general or regional anaesthetic technique must always be tailored to both the individual patient and the operation, taking into account the potential benefits and risks. The contribution of the individual anaesthetist in managing the RA (or GA) technique effectively and safely in order to achieve a good outcome must not be underestimated. Nevertheless, evidence does suggest that RA confers some outcome benefits beyond reducing acute pain. These include a reduction in chronic pain after some procedures, less PONV, and a clear reduction in pulmonary complications. RA has also been linked with a reduction in cancer recurrence, blood transfusion, SSI, intensive care unit admissions, and even a small reduction in mortality in some cases, but these data must be treated more cautiously. When CNB is used alone rather than in combination with GA, the benefits are often greater. Logically, utilising PNBs without GA and therefore avoiding CNB-mediated hypotension may offer the most benefit, yet the potential outcome benefits of PNBs are the area least studied.