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Local anaesthesia 

Local anaesthesia
Chapter:
Local anaesthesia
Author(s):

HBJ Fischer

DOI:
10.1093/med/9780199583386.003.0009
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date: 07 August 2020

Chapter 9 covers local anaesthesia, and the ten selected papers cover the progress of local anaesthesia from Koller’s original description (Paper 1) up to the impact of ultrasound-guided regional anaesthesia (USGRA) (Papers 9 and 10) in approximately chronological order. The purist may say that local anaesthesia is limited to the use of local anaesthetic drugs, which cause reversible sodium channel blockade (Paper 4). However, the discovery of opioid receptors and their role in producing segmental analgesia at a spinal cord level has had a profound effect on the way in which we use regional techniques; Paper 5 is included for that reason. Otherwise, papers selected are those that have advanced our technical knowledge and changed our clinical practice (Papers 2, 3, and 6) and papers that attempt to interrogate the best of the published randomized controlled studies to provide evidence of the important benefits and risks of local anaesthesia (Papers 7 and 8).

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