Anesthesiology

What Is Regional Anesthesia?

General anesthesia is a combination of medications that a person breathes through a mask or receives through a catheter in a vein to cause a person to fall asleep. In contrast, regional anesthesia is performed by an injection of medicine near a group of nerves to numb the area of your body that requires surgery.

There are several kinds of regional anesthesia. Two of the most frequently used are spinal anesthesia and epidural anesthesia, which are produced by injections made with great exactness in the appropriate areas of the back. They are frequently preferred for management of pain during childbirth and after abdominal or chest surgery. In addition, they can be used as the main anesthetic for abdominal or leg surgery.

Another common type of regional anesthesia is a peripheral nerve block, which is produced by injections made with great exactness near a cluster of nerves to numb the appropriate area of your body that requires surgery. Commonly, these injections are placed to numb the nerves to your arm or leg.

Can I receive both general and regional anesthesia at the same time?

Often, both general anesthesia and regional anesthesia are combined during the procedure, especially if one of the intentions of the regional technique is to help control pain after surgery. If you have regional anesthesia in addition to general anesthesia, this may possibly allow your anesthesiologist to use less general anesthesia which might allow you to recover faster after the surgery is finished.

How long will the regional anesthesia last?

If you receive a single injection of medicine to numb your nerves, you can expect 4-24 hours of pain relief after surgery. This may vary depending on the medication used. These injections are often used for pain control after bone surgery. For more painful procedures, we may also leave a small tube (catheter) that will be connected to a pain pump and give you medication continuously. That tube can give you pain relief while you are in the hospital and until your pain can be controlled with oral pain medicine.

What will I feel after the block takes effect?

No matter what regional anesthesia technique you receive, you will have some degree of temporary numbness, heaviness or weakness of your arms or legs at the end of surgery. This is normal. You might also not have the full muscle control of the affected part of your body. While your arm is numb, you should wear a sling while you walk or do any other activity. While your leg is numb, you should use assistance and crutches in order to get around. You should ALWAYS follow the instructions given by your doctors and nurses with regards to your activity level after ANY surgery.

What are the risks of regional anesthesia?

Any time a needle or catheter is inserted under the skin, bruising, infection or bleeding may occur. This is not very common. Sometimes the numbness and weakness last for a while longer after the medicine should have worn off. You may have residual effects of the medicine for another day or two. This is normal.

The specific risks of anesthesia vary with the particular procedure and the condition of the patient. You should ask your anesthesiologist about any risks that may be associated with your particular anesthesia. Your anesthesiologist carefully evaluates your condition, makes medical judgments, takes safety precautions and provides special treatment throughout the procedure. You should feel free to talk with your anesthesiologist about your options for anesthesia, pain control after surgery, their benefits and their possible side effects.

What are my choices for postoperative pain control?

Regional anesthesia is not your only choice for postoperative pain control. There are several choices for pain relief after surgery:

Intravenous "I.V." or Intramuscular "I.M." Medications. Pain medications that are injected into a vein or muscle will help to dull your pain but may not eliminate it completely.

Local Anesthesia. Other pain-relieving medications may be injected into the surgical incision by your surgeon. These medications are local anesthetics. They provide numbness or loss of sensation in a small area of your body.

Regional Blocks. Regional blocks can reduce the pain after surgery. Local anesthetics and other drugs are used for these procedures to reduce or "block" pain and other sensation over a wider region of the body.

Written by: 
Jaime Ortiz, M.D. 
Daniel Tolpin, M.D. 
August 2010