neuraxial vs regional anaesthesia
Oct 06, 2025
Understanding the Block: Neuraxial vs Regional Anaesthesia Explained 🏥
Neuraxial and regional anaesthesia are both techniques that use local anaesthetic agents to block nerve conduction, but they differ in where and how they are applied and how they contribute to anaesthesia and analgesia. This knowledge is essential for perioperative nurses to anticipate patient needs, recognise complications, and provide optimal care.
Definitions & Anatomical Sites 🔹
Neuraxial anaesthesia:
🔸 Anaesthetic techniques applied to the central nerve axis
🔸 Includes spinal (subarachnoid) anaesthesia, epidural anaesthesia, or combined spinal–epidural approaches
🔸 Inserted into or near the spinal cord’s subarachnoid space or epidural space
Regional anaesthesia:
🔸 More broadly encompasses peripheral nerve blocks
🔸 Targets nerve bundles or specific nerves outside of the central neuraxis
Purpose & Clinical Use 🌿
Neuraxial techniques:
🔸 Employed for major surgeries involving the abdomen, pelvis, lower limbs, and obstetrics (e.g. caesarean section)
🔸 Used for the intraoperative anaesthetic itself and/or significant postoperative analgesia
Regional techniques:
🔸 More frequently used to provide analgesia — often as adjuncts to general anaesthesia or for less extensive procedures
🔸 Used as opioid-sparing analgesia in the intra and postoperative phases
Advantages ❤️
🔹 Both techniques reduce the need for systemic opioids
🔹 Reduced nausea, sedation, and respiratory depression
🔹 Can be used to avoid general anaesthesia in some cases
Risks ⚠️
Neuraxial anaesthesia can produce:
🔸 Profound sympathetic blockade
🔸 Hypotension
🔸 Urinary retention
🔸 Spinal haematoma
🔸 Infection
Peripheral regional blocks can produce:
🔸 Nerve injury
🔸 Systemic toxicity of local anaesthetic
Due to the proximity to the central nervous system, the severity of some complications associated with neuraxial blocks can be greater. Therefore, monitoring and management of block height and distribution, and consideration of patient comorbidities such as anticoagulation, are especially important for perioperative nurses.
For perioperative nurses, it is important to understand the differences between block types, the onset and expected duration of blocks, as well as the potential systemic and regional effects and risks associated with them. Assessment of motor and sensory function to the affected area, safe and correct patient positioning, and management of catheter sites (if present) all form part of nursing care in relation to neuraxial and regional blocks and ensures patient safety and high-quality care.
Build Knowledge ✅
Improve Safety ✅
References:
Australian and New Zealand College of Anaesthetists. (2014). Guidelines for the management of major regional analgesia (PS03). Retrieved from https://anzca.edu.au/getContentAsset/a70212ec-6074-4fa5-a62b-742f1f64523a/PG03%28A%29-Guideline-for-the-management-of-major-regional-analgesia-2014.pdf
Folino, T. B., & Mahboobi, S. K. (2023). Regional Anesthetic Blocks. In StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK563238/
Pain Management Today. (2019, December). A multimodal approach to managing postoperative pain. Pain Management Today. https://painmanagement.medicinetoday.com.au/pmt/2019/december/feature-article/multimodal-approach-managing-postoperative-pain
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