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Canadian Journal of Anesthesia, Vol 25, 412-415, Copyright © 1978 by Canadian Anesthesiologists' Society

Balanced Regional Analgesia - An Hypothesis

P. J. TOMLIN M.B., B.S., F.F.A.R.C.S.1 and JON GJESSING M.D.2

1 Department of Anaesthetics, Queen Elizabeth Hospital, Edgbaston, Birmingham, B15 2TH, England
2 Department of Anaesthetics, Sundsvall Hospital, Sundsvall, Sweden

An hypothesis is advanced, based upon observation of patients undergoing selected types of regional analgesic blocks, that total patient care during any regional analgesic technique consists of maintaining a balance of local analgesia, tranquillity and the use of a centrally acting analgesic. The latter is required to relieve non-specific distress unrelated to the operation which appears to be caused by a disturbance of sensory input to the cerebral cortex, possibly the proprioceptive input. A small group of patients will not respond to any sedation accompanying regional analgesia and need general anaesthesia. It is suggested that failure to appreciate all three parts of this triad may contribute to uncertainty of patient control during regional block.






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Copyright © 1978 by the Canadian Anesthesiologists' Society.