Local anaesthesia
Appropriately used, local anaesthesia can give complete analgesia in a wide variety of clinical situations with minimal drawbacks. Particular indications include:
- painful procedures, e.g. chest drains
- intra- and postoperative analgesia
- analgesia after trauma
- infants with respiratory disease who are unable to tolerate large doses of opioid
Local anaesthesia may take several forms:
- surface anaesthesia:
- indicated, e.g. for trauma such as repeated heel pricks
- EMLA cream is applied sparingly every 4 hours
- in children over a year, the cream is applied thickly and left under an occlusive dressing
- local infiltration:
- e.g. peripheral nerve or regional block
- used to enhance analgesia during surgery
- central extradural block can be administered by an experienced team
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