Regional anesthesia outside the operating room:  indications and techniques.
OBJECTIVE
Regional anesthesia is not only performed in the operating room. There are indications for the use of these techniques for pain relief in the emergency department and for anesthesia support of procedures outside the operating room. In this review, we will provide an overview of the indications for the regional techniques performed in the out-of-operating room environment.


RESULTS
In the emergency department, patients may experience significant pain, and adequate analgesia is not always provided. Regional analgesia is effective and indicated for many trauma situations including hip fracture, reduction of shoulder dislocation, treatment of upper limb fractures and multiple rib fractures.Ultrasound guidance makes the performance of regional blocks more accessible and safer for use in the emergency department setting.For therapeutic procedures outside the operating room, regional anesthesia is possible for uterine artery embolization and for postoperative analgesia after implantation of cervical brachytherapy needles.


CONCLUSIONS
Regional anesthesia is a valuable option for analgesia in trauma patients, enabling improved pain control in the emergency department and has benefits in the anesthetic management of therapeutic procedures outside the operating room. For many blocks, ultrasound guidance is useful.
University Hospitals Leuven, Department of anesthesiology, Leuven, Belgium. frederik.debuck@uzleuven.be
Frederik
F
De Buck
Sarah
S
Devroe
Carlo
C
Missant
Marc
M
Van de Velde
D015360:Analgesia, Epidural / Q000379:methods; D000765:Anesthesia, Conduction / Q000379:methods*; D004621:Embolization, Therapeutic / Q000379:methods; D004636:Emergency Service, Hospital; D005267:Femoral Nerve; D006801:Humans; D035002:Lower Extremity / Q000293:injuries; D009407:Nerve Block / Q000379:methods; D009873:Operating Rooms; D012253:Rib Fractures / Q000601:surgery; D012782:Shoulder / Q000601:surgery