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Spinal anaesthesia (or spinal anesthesia), also called spinal block, subarachnoid block, intradural block and intrathecal block, [1] is a form of neuraxial regional anaesthesia involving the injection of a local anaesthetic or opioid into the subarachnoid space, generally through a fine needle, usually 9 cm (3.5 in) long.
Nerve block or regional nerve blockade is any deliberate interruption of signals traveling along a nerve, often for the purpose of pain relief. Local anesthetic nerve block (sometimes referred to as simply "nerve block") is a short-term block, usually lasting hours or days, involving the injection of an anesthetic, a corticosteroid, and other agents onto or near a nerve.
Neuraxial blockade is local anaesthesia placed around the nerves of the central nervous system, such as spinal anaesthesia, caudal anaesthesia, epidural anaesthesia, and combined spinal and epidural anaesthesia. [1] [2] The technique is used in surgery, obstetrics, and for postoperative and chronic pain relief. [3]
Nerve blocks are also used as a continuous infusion, following major surgery such as knee, hip and shoulder replacement surgery, and may be associated with lower complications. [13] Nerve blocks are also associated with a lower risk of neurologic complications compared to the more central epidural or spinal neuraxial blocks. [2]: 1639–41
The most peripheral technique is topical anesthesia to the skin or other body surface. Small and large peripheral nerves can be anesthetized individually (peripheral nerve block) or in anatomic nerve bundles (plexus anesthesia). Spinal anesthesia and epidural anesthesia merge into the central nervous system. Injection of LAs is often painful.
CPN can be performed by percutaneous injection either anterior or posterior to the celiac plexus. [4] CPN is generally performed complementary to nerve blocks, due to the severe pain associated with the injection itself. Neurolysis is commonly performed only after a successful celiac plexus block. [4]