Considerations for Regional Anaesthesia in the Prehospital Environment

Regional anesthesia has become an established and effective form of in-hospital pain relief, offering significant benefits than systemic analgesia. Its application in the prehospital setting remains limited and underused. The prehospital environment poses many different challenges compared with in-hospital care, and, therefore, practice cannot necessarily be directly translated. This review explores the current prehospital applications of regional anesthesia, perceived advantages, and indications. It evaluates contraindications and complications, in particular the risk of masking compartment syndrome and iatrogenic nerve injury in the traumatically injured patient, and the implications for prolongation of scene time. Finally, it addresses some of the practical, logistical, safety, and training considerations for implementation.