[The role of ambulatory locoregional anesthesia].
The use of regional anaesthesia in day care practice is discussed. Five criteria of discharge are described: the four "A"s: awake, ambulation, alimentation, analgesia plus micturition. Complementary sedation with the regional block, if needed, should be midazolam and fentanyl. These drugs should be titrated in order to administer the efficient minimal dosage. The main techniques of regional anaesthesia are as follows: for upper limbs, intravenous regional anaesthesia, axillary and interscalenic brachial plexus blocks; for the lower limbs epidural and spinal blocks. However, urinary retention and orthostatic hypotension can occur. Furthermore the risk of headache is not a contraindication to an ambulatory practice if some guidelines are observed. In addition, penile blocks and caudal blocks are widely used in pediatrics.
Ecoffey
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Département d'Anesthésie-Réanimation chirurgicale, Hôpital de Bicêtre, Université Paris-Sud, Le Kremlin-Bicêtre.
D000556:Ambulatory Surgical Procedures; D000765:Anesthesia, Conduction / Q000379:methods*; D006801:Humans