General or regional anaesthesia--pro regional.

Consider yourself in a hospital emergency entrance room; a young, previously healthy person is brought in with an intoxication. He has taken an oral overdose of benzodiazepines, neuroleptics and barbiturates; as well as injected himself with an opioid. He is deeply comatous and hypotensive, with obstructed airways and inadequate respiration. His life is definitely threatened, he needs highly qualified care in an intensive care unit and he will take time to recover. When you consider the type of drugs, the probable doses and the symptoms in this patient, you should agree upon considering general anaesthesia as wontrolled intoxication,,, we even add inhalational agents and curare in many cases. Thus, in cases of general anaesthesia the patient is totally dependant upon continous expert care in order to survive, whereas with regional techniques the potential problems are more occational, although still demanding expert care in order to be delt with. In order to discuss the benefits of regional anasthesia (11, it is usually helpful to sort the arguments into areas of safety, quality and economy.