Elderly patients are more sensitive to local anaesthetic agents. Central techniques produce greater degrees of sensory and motor block, and the risk of hypotension due to sympathetic block is greater also. What little evidence there is suggests that the effects of this greater sensitivity are seen after peripheral nerve block as well. However, this group is also very sensitive to the side effects of other analgesic drugs, especially the opioids, so regional techniques have much to offer, especially given the greater incidence of intercurrent disease. Distorted anatomy increases the technical...

Elderly patients are more sensitive to local anaesthetic agents. Central techniques produce greater degrees of sensory and motor block, and the risk of hypotension due to sympathetic block is greater also. What little evidence there is suggests that the effects of this greater sensitivity are seen after peripheral nerve block as well. However, this group is also very sensitive to the side effects of other analgesic drugs, especially the opioids, so regional techniques have much to offer, especially given the greater incidence of intercurrent disease. Distorted anatomy increases the technical challenge of block placement in many patients, and particular care is needed to avoid injury to joints and skin, so the use of regional techniques in this age group requires particular skill and experience.