Longnecker's Anesthesiology > Part 4. Managing Anesthesia Care > Section D. Regional Anesthesia > Chapter 49. Managing Adverse Outcomes during Regional Anesthesia Ban C.H. Tsui, MSc, MD, FRCPC, and Brendan T. Finucane, MBBCh, FRCPC

Key Points

"1. Safe regional anesthesia begins with a thorough knowledge of anatomy. In Labat's words, "anatomy is the foundation upon which the entire concept of regional anesthesia is built." Studying the anatomy of the major plexuses and peripheral nerves is critical for learning regional anesthesia and avoiding its complications.

2. Prior to performing regional anesthesia, it is imperative to thoroughly discuss the techniques, and their limitations, with the patient. Assessing which patients are most appropriate for performing these techniques on is important, as some are not suitable candidates (e.g., those with major anatomic distortion or serious mental illness).

3. One of the most important principles for safe regional anesthesia is provision of a comfortable patient environment. If a patient suffers as a result of one's intervention, a basic principle of the practice of anesthesia has been violated.

4. Resuscitation equipment must be immediately available when performing regional anesthesia and one must be prepared, at all times, to anesthetize and resuscitate the patient when necessary.

5. Knowing when to stop performing regional anesthesia techniques is crucial. Dogged persistence in the face of failure is inadvisable. Do not hesitate to seek assistance when faced with difficulties and be prepared to change to an alternative route of anesthesia if persistent failure (more than 3..."