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Regional anesthesia in resource-limited and disaster environments: a daring discourse
  1. Scott Hughey1,2,
  2. Jacob Cole3,2,
  3. Benjamin Drew4,2,
  4. Adam Brust5,2 and
  5. Eric Stedjelarsen3,2
  1. 1Anesthesiology and Pain Medicine, US Naval Hospital Okinawa, Okinawa, Japan
  2. 2Naval Biotechnology Group, Portsmouth, Virginia, USA
  3. 3Anesthesiology and Pain Medicine, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA
  4. 4Naval Medical Center San Diego, San Diego, California, USA
  5. 5Anesthesiology, US Naval Hospital Pensacola, Pensacola, Florida, USA
  1. Correspondence to Dr Scott Hughey, Anesthesiology and Pain Medicine, US Naval Hospital Okinawa, Okinawa, Japan; scott.b.hughey{at}


Regional anesthesia (RA) is commonly used in perioperative settings of developed and well-resourced environments. RA has significant potential benefits when used in resource-limited environments, including disaster, mass casualty, and wartime environments. RA offers benefits over general anesthesia and opioid-based analgesia, including decreased risk of complications, decreased reliance on mechanical ventilation, improved cost efficiency, and others. The decreasing cost of ultrasound matched with its smaller size and portability increases the availability of ultrasound in these environments, making ultrasound-guided RA more feasible. This daring discourse discusses some historical examples of RA in ultralow resource environments, both man-made disasters and natural disasters. Future investigations should increase the usefulness and availability of RA in resource-limited environments.

  • Emergency Medicine

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  • Contributors All authors contributed equally to the conception, analysis, manuscript creation, and final approval.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.