Rheumatoid arthritis and regional anaesthesia.

Of the many conditions that patients sadly suffer from and they worry about the interaction between that condition and regional anaesthesia, one of the commonest ones raised is that of rheumatoid arthritis, a chronic arthritis that affects many joints in the body. The answer is that although people often ask about any impact of rheumatoid arthritis on the use of regional anaesthesia, The answer is that there are positive advantages to my mind of using regional anaesthesia for patients with rheumatoid arthritis. Very often the procedures they undergo are related to that arthritis, they're painful procedures and providing regional anaesthesia can make you go numb or that part of your body go numb. Some hours afterwards the experience of pain relief is much better with regional anaesthesia than with general anaesthesia. Having rheumatoid arthritis doesn't to mean that you can't have regional anesthesia. The only difference that it would make is some patients with severe rheumatoid arthritis find it difficult to get into position to allow the safe performance of regional anesthesia. If I was performing a spinal or an epidural, I'd want somebody to curl up into a little ball to open out the bones in their back. This may not be easy for somebody with arthritis. If I was doing an injection in the base of the neck, I may want the patient to turn away to display the anatomy better for the safe performance of regional. that may not be terribly easy for somebody with rheumatoid arthritis. There are situations in fact where regional anaesthesia is much safer for a patient with rheumatoid arthritis. Some patients with rheumatoid arthritis find it very difficult to move their neck and very difficult to open their mouth and that can make it sometimes on rare occasion dangerous to administer general anaesthetic because it may be difficult to clear the airway to allow oxygen to go into the airway. So very often when I'm managing a patient with severe rheumatoid arthritis, I will recommend regional anaesthesia as a safe and effective way of avoiding general anaesthesia.