Regional anaesthesia has found its uses in many aspects of orthopaedic surgery including, more recently, spine surgery. Neuraxial or regional anaesthesia are often the preferred techniques for surgical anaesthesia in patients with multiple comorbidities. For instance, osteoporosis-related complications such as hip fractures are common in the growing geriatric population. These patients are often high-risk surgical candidates with limited cardiopulmonary reserve. Successful central neuraxial block (CNB) or peripheral nerve block (PNB) may avoid complications associated with general anesthesia such as airway difficulties, postoperative respiratory impairment and haemodynamic instability. Fewer systemic drugs may reduce postoperative delirium, nausea and vomiting, and improved blood rheology may reduce the incidence of deep vein thrombosis.

Regional anaesthesia also has an important role in multimodal analgesia by providing excellent pain relief, reducing perioperative opioid consumption and their side effects, and improving patient satisfaction. Recent development of motor-sparing regional anesthetic techniques such as the pericapsular nerve group (PENG) block may result in earlier mobilization and rehabilitation. This may translate to quicker recovery, earlier discharge, fewer nosocomial complications and economical benefits.