• K Ode, S Selvaraj, and A F Smith.
• Department of Anaesthesia, Royal Lancaster Infirmary, Lancaster, UK.
• Anaesthesia. 2017 Jan 1; 72 Suppl 1: 70-75.

AbstractThis review attempts to draw on the published literature to address three practical clinical questions. First, what means of testing the degree of regional blockade pre-operatively are available, and can eventual success or failure be determined soon after injection? Second, is it possible to predict if a block inserted after the induction of general anaesthesia will be effective when the patient wakes? Third, what features, and what duration, should cause concern when a block does not resolve as expected after surgery? Although the relevant literature is limited, we recommend testing of multiple sensory modalities before surgery commences; temperature and thermographic changes may offer additional early warning of success or failure. There are a number of existing methods of assessing nociception under general anaesthesia, but none has yet been applied to gauge the onset of a regional block. Finally, criteria for further investigation and neurological referral when block symptoms persist postoperatively are presented.© 2017 The Association of Anaesthetists of Great Britain and Ireland.

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