Hi Prajjwal.....

Depends very much on the procedure,and patient/surgical requirements,as with any anaesthetic.

Regional anaesthesia has many advantages(e.g post op pain relief,no problems with extubation etc etc)but may not suit many procedures.

Airway protection,especially with patients whose airway reflexes may not be adequate is of paramount importance,and personally,I would have to weigh that up very carefully when considering RA in some patients groups.

Anaesthesia has often been said to be all about risk management,and each of us has to weigh up those risks and balance them against the benefits for an individual patient.

Don't forget also that a failed or difficult intubation in a patient with a full stomach can result in catastrophic aspiration.....I'm sure we've all seen the consequences.

Thanks Ian Ewart! Not considering those cases where muscle relaxant is requiired.....

But .. let’s say we have emergency lower limb surgery with full stomach then is spinal anesthesia or general anesthesia in airway point of view?

Conscious patient will never aspirated?

But is it safe to proceed without secure airway?

Any guidelines or research?

Regional anesthesia is safe in such conditions. According to Michael Robinson et al published inBJA Education. https://academic.oup.com/bjaed/article/14/4/171/293792

Great answers above. I will only add- be very careful of the level of block- hypotension may provoke nausea and vomiting and increase the chances of aspiration.

Nerve blocks?

Thank you Swagata Tripathy and Apurb Sharma

Regional is better as long as the surgery is amenable to it.

I developped a cream that penetrates immediately the skin for topic anesthesia

without AINS nor pharmaceutical ingredients

We have some results on pain in the area of bones

kind regards

Jean debetencourt

Neither is safe unless procedure is superficial requiring only local infiltration

Regional application of anesthesia is also advisable to add diclofenac in the formula instead of distributing it through the stomac and the digestive tube that causes medical problems later

topic application does not need the mean of blood circulation through injection (systemc)

The finger bones are reached (arthrosis) such as the menisk through skin penetration . Deeper tissues are not reached, I agree

Thank you all.

In case of emergency Cesarean section - an agitated parturient with full stomach (not a very rare scenario at mid or late night) - even in regional anesthesia - it warrants special precaution to prevent aspiration. Thanks.

Too difficult case for my anesthesy method near the cause of pain. I concentrate on skin penetration of my cream and decrease of pain. First target is arthrosis...step by step...small step...very prudent

All,

I am afraid that the only one line answer that works here is: “It depends”.

The surgical procedure, patient health, emergency status??

We can all present a case for either depending on the situation. Regional is not always the right or wrong answer And the same goes for general anesthesia.

Regards,

Christopher

Christopher A Smith

Excellent answer to this.

Many of us simply say “this technique is best” without considering the risk/benefit balance for an individual overall.

I would describe anaesthesia often as risk as risk management applied to medical situations and we need to remember that no one technique will fit every example.

It is still a matter of debate. Both has its pros and cons. But one thing I must Say that, RA as a part of Multi-modal analgesia definitely improves the patient outcome. so, try to incorporate RA as much as possible in your practice which will definitely improves the patient management.

regional anesthesy should be the priority

JEAN DB