Chapter 8: Guidelines for the Provision of Regional Anaesthesia Services 2024
A multidisciplinary team, including all relevant healthcare professionals as appropriate, should develop local policies pertinent to regional anaesthesia.
A multidisciplinary team, including all relevant healthcare professionals as appropriate, should develop local policies pertinent to regional anaesthesia.
Local policies should be in agreement with relevant published national guidelines.
Local policy on consent should have a section dedicated to regional anaesthesia.
National guidelines adopted locally should be easily accessible to all staff caring for patients undergoing regional anaesthesia. These include but are not limited to:
Children, pregnant women, elderly people, those with comorbidities (e.g.; renal failure, cardiac dysfunction or liver insufficiency) and critically ill patients are at higher risk of Local Anaesthetic Systemic Toxicity (LAST). Clear guidelines on the management of LAST in this population including the administration of lipid emulsion therapy, should be immediately available.6
In establishing local guidelines, departments may wish to consult the RA-UK website for examples of good practice in relation to regional anaesthesia.
There should be a dedicated trained assistant (i.e. an ODP, anaesthetic nurse or equivalent) who holds a valid registration with the appropriate regulatory body, immediately available in every location in which regional anaesthesia care is being delivered.28
Practitioners performing regional anaesthesia should have undergone adequate training. Such practice should be in the setting of an appropriate local training programme, with strict adherence to governance protocols and regular review of quality and safety.15
Local policies should be in place to define the scope of intraoperative monitoring by non-anaesthetist health care workers. These policies should meet the criteria proposed by RA-UK.16
Appropriately trained healthcare workers monitoring patients who have undergone regional anaesthesia should be specifically trained with their competencies clearly defined according to the Association of Anaesthetists’ requirements for post-anaesthesia care unit (PACU) recovery nursing.29 This individual should be able to recognise symptoms and signs of local anaesthetic toxicity.25