This review discusses sedation for regional anaesthesia in the adult population. The first section deals with general aspects of sedation and shows that the majority of patients receiving sedation for regional anaesthesia are satisfied and would choose it again. Methods of assessing the level of sedation are discussed with emphasis on clinical measures. The pharmacology of the drugs involved in sedation is discussed, with propofol and remifentanil appearing to be the combination of choice for sedation in regional anaesthesia. The techniques for administering sedation are discussed and replacement of the traditional repeated boluses or continuous infusion with pharmacokinetic and patient-controlled systems is supported. Patient satisfaction studies suggest that patient-controlled systems are preferred.

Both methods provide efficient postoperative analgesia. However, double epidural catheter technique provides better postoperative analgesia, earlier recovery of bowel function, fewer side effects, and a higher patient satisfaction.

Continuous application of 0.2% ropivacaine through an IC catheter after Bankart repair with IC bone grafting is an effective method for pain relief for the first 48 h, with few adverse effects and high patient satisfaction. The benefit of this technique is still present after 3 months.

Background: Perineural catheters (PNCs) are increasingly being used. Few data are available on the infectious complications of PNCs. The incidence and localization of local inflammation and infection associated with PNCs were assessed. Methods: PNCs placed under sterile conditions for regional anesthesia and post-operative analgesia were evaluated prospectively. Local inflammation was defined as redness, swelling or pain on pressure at the catheter insertion site. Infection was defined as purulent material at the catheter insertion site with or without the need for surgical intervention. Results: In total, 2285 PNCs were evaluated: 600 axillary, 303 interscalene, 92 infraclavicular, 65 psoas compartment, 574 femoral, 296 sciatic and 355 popliteal. Local inflammation occurred in 4.2% and infection in 3.2%. The duration of PNC placement was a risk factor (P < 0.05). Surgical intervention was necessary in 0.9%. No late complications occurred in any patient. Interscalene catheters were associated with an increased risk of infection (4.3%; P < 0.05). Anterior proximal sciatic catheters were associated with a lower risk of local inflammation (1.7%; P < 0.05) and infection (0.4%; P < 0.05). Staphylococcus epidermidis and Staphylococcus aureus were isolated in 42% and 58% of catheter tip cultures, respectively. Conclusion: In the present study population, infection of PNCs was a rare occurrence, but the incidence increased with the duration of PNC placement, and close clinical monitoring is required.