The purpose of this handbook is to provide clinicians with an easy access to the art and science of regional anaesthetic techniques. We believe we have provided the reader with a practical guide, in the familiar format of the Oxford Handbook series, combined with aspects of a larger reference text, in a handy pocket-sized book. We have deliberately included both landmark or peripheral nerve stimulator-guided techniques and ultrasound techniques to provide a complete clinical guide. Anatomy features strongly throughout the chapters as it remains the cornerstone of good clinical regional anaesthesia, whether using an ultrasound or a peripheral nerve stimulator, and indeed the legendary Alon P. Winnie remarked ‘Regional anesthesia is simply an exercise in applied anatomy’. The first section covers a wide range of topics on the background of regional anaesthesia. There is an amusing and enlightening chapter on the history of regional anaesthesia. There are chapters covering the basic science of physiology of pain, pharmacology of drugs, physics and use of ultrasound, and peripheral nerve stimulators. Whilst maintaining a strong science base, we have tried to make these chapters as clinically relevant as possible and have useful clinical tips on the practice of regional anaesthesia and frequent summaries of published evidence. There are also sections to deal with risks and complications of regional anaesthesia. Included in this section are some more advanced techniques of wound and nerve catheters and paediatric regional anaesthesia.

The remainder of the book provides detailed descriptions of almost all conceivable regional anaesthetic techniques over the whole of the body. The obvious upper and lower limb blocks are there, with descriptions of all common approaches. Unlike some pocket guides we have included head and neck blocks and ophthalmic regional anaesthesia. We have also covered trunk blocks, those of both the chest, including the increasingly popular paravertebral blocks, and of the abdominal wall; such as TAP and rectus sheath blocks. Each chapter provides a representation of the complexity of the block, the indications, contraindications, and complications. There is an overview of the anatomy with frequent diagrams to illustrate. The step-bystep ‘hands on’ guides of the blocks are again complemented with diagrams to aid understanding and to help the practice of block performance and of course ultrasound images of the appropriate anatomy. There are frequent helpful clinical tips and hints throughout.

Although familiar to many, we have included a section describing central neuraxial techniques. Although the basics of the practical techniques are covered, there is perhaps more of a focus on the use of these techniques in certain situations and there is a chapter to describe and illustrate the emerging skill of spinal ultrasonography in regional anaesthesia.

There are many contributors to the text of the book; all are clinical anaesthetists with an enthusiasm and passion for regional anaesthesia. Many of them will be familiar names from the ‘aristocracy’ of regional anaesthesia in this country, teaching and preaching on national and international stages over many years of dedication. Our thanks to them all for their expert contributions and their forbearance on bringing this book to publication.
The text and images have been checked, but we apologies in advance for any errors (or differing points of view) and would welcome your feedback, comments, and corrections. Whilst we hope that this handbook provides an invaluable guide and reference, it is not a substitute for the proper study, training, practice, and mentorship to attain proficiency in the safe and effective delivery of regional anaesthesia to your patients.

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