YEAR 05 • ADVANCED CLINICAL

Anaesthesia & Critical Care

20 learning units • 100 chapter sections • 200 explained questions. Prepare patients for anaesthesia, recognise perioperative emergencies and understand organ support, critical-care teamwork and recovery.

Original RAHBAR study material for the Year 5 learning pathway. Clinical cases support supervised undergraduate learning. Treatment choices, doses and procedures must follow current local protocols and the responsible clinical team. References & further reading ↓

MODULE 06 / 20

Local & Regional Anaesthesia

Understand regional techniques, patient selection and recognition of block-related complications.

Quick revision ↓ Medical Dictionary

01Principles

Local anaesthetics interrupt nerve conduction, while peripheral and neuraxial techniques target different anatomical sites. A regional block may provide surgical anaesthesia, analgesia or both. Explain expected effects and duration, and confirm that the planned technique is suitable for the operation and patient preferences.

02Patient selection

Review consent, infection, anticoagulants, bleeding risk, neurological history and relevant cardiovascular disease. Contraindications depend on the technique and circumstances. Drug timing around neuraxial procedures requires current agent-specific guidance; a routine coagulation result does not answer every anticoagulant question.

03Monitoring and readiness

Regional anaesthesia still requires appropriate monitoring, intravenous access and rescue capability. Sedation can add respiratory risk. Confirm block effectiveness before proceeding and plan for inadequate or failed block rather than assuming a technically completed injection guarantees surgical anaesthesia.

04Recognise toxicity

Local anaesthetic systemic toxicity can cause neurological symptoms, seizures or cardiovascular collapse, with variable presentation. Stop further administration, call for help and use the current specialist emergency checklist, including lipid therapy when indicated. Prevention includes dose calculation and trained technique, but risk is not eliminated completely.

05Neuraxial complications

Hypotension, unexpectedly extensive block or respiratory compromise needs prompt assessment and treatment. New or progressive neurological deficit after a neuraxial procedure, particularly with back pain or sphincter symptoms, needs urgent specialist evaluation for compressive complications. Do not label all persistent weakness as an ordinary block effect.

High-Yield Revision

Regional anaesthesia still needs monitoring and rescue readiness.
Anticoagulant decisions are drug- and technique-specific.
Persistent new neurological deficits require assessment.

Common Pitfalls

Assuming a normal coagulation test excludes every anticoagulant effect.
Dismissing cardiovascular collapse as unrelated to local anaesthetic.

References & Further Reading

Read the relevant guideline sections alongside these original clinical teaching cases. Local pathways, available services and individual patient factors determine care.

Reference review: 29 September 2026. Consult current local protocols for prescribing, procedures and escalation.