Managing acute pain in trauma with regional anaesthesia

Trauma is a significant cause of hospital presentations and admissions in the UK, comprising a diverse selection of patients with differing analgesic needs and levels of comorbidity. Pain from the initial injury and subsequent treatments such as closed reductions and surgery is often severe and can lead to discomfort, difficulty in nursing care physiotherapy, and unwanted admissions. Regional anaesthesia is perfectly placed to provide an individualized analgesic strategy for each trauma patient that gives significant pain relief, and reduces reliance on opiate medications which have a significant side-effect profile especially in the increasingly elderly population presenting to hospitals with trauma. This article explores the advantages and drawbacks of regional anaesthesia in trauma, and summarizes the specific patient considerations in some of the more common injuries that present to hospitals in the UK. We also look to the future with newer innovations and novel devices coming into more frequent use and how they may be used to benefit the trauma patient.