Regional anaesthesia: Spinal and epidural application

The goal of the present chapter is to revisit the conclusion of a review published 5 years ago in terms of the experimental and clinical data published from 1996 to 2000. It intends to provide the anaesthesiologist with an objective idea of what can be expected from this class of substance in the everyday practice of regional anaesthesia/analgesia. The chapter is divided in four parts, scrutinizing respectively the drugs available, the mechanisms of action, the clinical use and the side-effects. It is concluded, in accordance with the first review, that α2-adrenergic receptor agonists improve the reliability and efficacy of regional anaesthesia. The best way to take advantage of these drugs for regional anaesthesia/analgesia is to combine them, at low dose, with other classical drugs via the spinal or epidural route. In particular, clear evidence exists that α2-adrenergic agonists should be combined with the opioids any time the latter are required