Monitoring and Sedation in Regional Anesthesia

  • James Kim
  • Jeff Gadsden


Multiple monitors are employed during every general anesthesia case to prevent adverse outcomes. In regional anesthesia, monitors are specifically used to permit the safe administration of sedation (oximetry, blood pressure monitoring), as well as to prevent procedural-related catastrophes such as nerve injury, local anesthetic systemic toxicity (LAST), and pneumothorax. Each monitor has strengths and weaknesses, but when used in combination, they serve to act in a complementary manner. Ultrasonography permits the direct visualization of nerve or plexus targets, guides needle advancement, and aids in the confirmation of appropriate spread of injectate. Ultrasonography has also been demonstrated, likely via reduced volumes of injectate required, to significantly reduce the incidence of LAST. Nerve stimulation and injection pressure monitoring also work in tandem to prevent injurious needle-nerve contact. Finally, appropriate use of sedative drugs allows for the safe and effective practice of regional anesthesia techniques.


Regional anesthesia Monitors Sedation Ultrasound Nerve stimulation Injection pressure monitoring BIS Cerebral oximetry 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • James Kim
    • 1
  • Jeff Gadsden
    • 2
  1. 1.AnesthesiologyDuke University Medical CenterDurhamUSA
  2. 2.Department of AnesthesiologyDuke University Medical CenterDurhamUSA

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