1. The comparative safety of regional anesthesia compared with general anesthesia cannot be accurately determined. Serious complications associated with the performance of regional anesthesia include cardiac arrest, radiculopathy, cauda equina syndrome, and paraplegia (Table 56-13: Risk Factors for Nerve Injury During the Performance of Regional Anesthesia). The incidences of cardiac arrest and neurologic complications are higher after spinal anesthesia than after all other types of regional procedures (Table 56-14: Advantages of Ultrasound-Guided Regional Anesthesia).
2. Ultrasound-guided regional anesthesia has several advantages but does not completely eliminate all of the risks associated with the performance of peripheral nerve blockade (nerve injury, local anesthetic toxicity, pneumothorax). Low-volume ultrasound-guided regional anesthesia of the brachial plexus can decrease the risk of hemidiaphragmatic paresis following an interscalene approach and almost eliminate it following a supraclavicular approach.

Acute Pain Management

1. Acute Pain Defined
2. Anatomy of Acute Pain
3. Pain Processing
4. Chemical Mediators of Transduction and Transmission
5. The Surgical Stress Response
6. Preemptive Analgesia
7. Strategies for Acute Pain Management
8. Assessment of Acute Pain
9. Opioid Analgesics
10. Nonopioid Analgesic Adjuncts
11. Methods of Analgesia
12. Continuous Peripheral Nerve Blockade Caveats
13. Complications from Regional Anesthesia
14. Perioperative Pain Management of Opioid-Dependent Patients
15. Organization of Perioperative Pain Management Services
16. Special Considerations in the Perioperative Pain Management of Children