Local and regional anaesthetic techniques in wound management

Adequate pain control is vital in perioperative care. Pain affects respiratory and cardiovascular function with knock-on effects on many other organs and systems. Surgery is also recognized as one of the most frequent causes of chronic pain, with surgical approach and level of pain experienced being modifiable risk factors for the development of chronic post-surgical pain. Local anaesthetic can be used to facilitate pain relief either by local infiltration or nerve blocks, increased mobility and a better perioperative and postoperative experience for the patients. There are two pharmacological types, esters and amides, that have different uses. Commonly used blocks are brachial plexus block, Bier's block, femoral nerve block, spinal block and epidurals. These can be used alone or in combination with a general anaesthetic.