Regional Anesthesia

• What Is Regional Anesthesia?
• When Is Regional Anesthesia Used Over Other Types of Anesthesia?
• How To Prepare for Regional Anesthesia
• How Is Regional Anesthesia Administered?
• Are There Risks Associated With Regional Anesthesia?
• Recovering From Regional Anesthesia

In order to block pain from an area of the body instead of putting the patient to sleep, surgeons and physicians will use regional anesthesia.

Regional anesthesia is delivered to an area of nerves through an injection or small tube catheter by an anesthesiologist. It is used when local anesthesia targeted directly towards the directed area isn't enough, but general anesthesia is too much or is unnecessary for the procedure in question. Sometimes, regional anesthesia is also used when it's better for the patient to be awake and talking to the surgeon, while other times it's used in combination with medicine like propofol to sedate the patient for the duration of the procedure.

There are different kinds of regional anesthesia, including peripheral nerve blocks and spinal and epidural anesthesia.

Peripheral Nerve Blocks

Nerves and nerve clusters all connect to the spine and spinal cord. Because of this, they have a long way to travel — which means they can be blocked and intercepted many times along the way.

Peripheral nerve blocks are a type of regional anesthesia that target a specific nerve or group of nerves and block the neural pathway from translating pain in that nerve to the brain. Targeting a specific group thus blocks pain in the part of the body that connects to that nerve or group. Procedures that use peripheral nerve blocks include procedures on the face, arms, legs, and extremities like hands and feet.

There are different types of peripheral nerve blocks that relate to the specific nerve that's being targeted. For example: a brachial plexus block involves a nerve group in the arm and shoulder region, and a femoral nerve block involves the nerve in the legs. These are the two most common types of peripheral nerve blocks.

Spinal and Epidural Anesthesia

Epidural anesthesia is similar to a peripheral nerve block and is most commonly used during childbirth, though it's used for many other procedures as well. An anesthesiologist will place a catheter in your back that will administer regional anesthesia as often as it's needed to block and manage pain.

Spinal block anesthesia is administered using a small needle. An anesthesiologist will use that needle to give you a single medicine injection in your back, near your spine. This medicine provides immediate numbing and relief, which will last about two to four hours, depending on the medication used and the strength provided.

When you think of anesthesia, you probably think about being put to sleep. That's general anesthesia, where a patient is rendered unconscious for the duration of a surgery or other related procedure. You have zero awareness or recollection of the entire event. For regional anesthesia, a specific area of your body is numbed, but you retain consciousness and awareness of what's going on around you.

Sometimes, depending on the procedure being performed, it's beneficial for the patient to retain consciousness and, on occasion, talk with the surgeon during surgery. Childbirth is a great example of needing regional anesthesia — pain numbing is needed, but the patient must remain conscious to follow through with birth. If a C-section were needed, a spinal block would likely be used instead or in addition to an epidural.

Other times, regional anesthesia may be used in combination with general sedation; this way, only a specific part of the body is numbed, and the patient is asleep for a short period of time while the procedure happens.

Depending on your procedure, you will receive a specific list of instructions from your surgeon and your anesthesiologist for preparation prior to the procedure and what to expect during. The rules differ depending on the procedure, but in general, you can expect something like this:

1. Only take the medicine you are specifically told you can take, and avoid all other ones, even if they're medications you take regularly.
2. Follow the given instructions on when to stop eating and drinking.
3. Review the list of benefits and risks as well as the consent form before signing, and ask any questions before signing, if you have any. At this time, be sure to tell your doctor of any allergies or sensitivities you have, regardless of whether or not you think they'd be relevant.
4. Read through the provided list of what to expect on the day of the procedure. Note your time of arrival and show up at the hospital or outpatient facility on time.
5. Take the right precautions for post-surgery. Coordinate a driver to take you home, pre-prepare the food you'll need, and so on.

How regional anesthesia is given to patients depends on which areas need to be numbed. For some areas, an anesthesiologist will inject anesthetic near a nerve or bundle of nerves. This bathes the nerves and blocks pain in the area, preventing the brain from receiving the information and processing it as pain.

With an epidural or spinal block, anesthetic is injected near your spinal nerves. A flexible epidural catheter is often placed at that injection site so anesthetic and other important medications can be consistently administered when needed. For these types of regional anesthesia, you will be seated or lying on your back.

For a peripheral nerve block, how it's administered depends on where it's being given on the body. For the most part, you will be lying on your back or stomach.

For all of these methods of regional anesthesia, the anesthetic is never administered inside of the nerves; it's always administered near the nerve or nerve cluster.

As with any procedure, there are some risks associated with using regional anesthesia, although the risks are relatively minimal. They include:

• Slight tingling and burning when the anesthesia is administered
• Light bleeding or bruising due to the needle or catheter
• Decreased blood pressure
• Mild itching
• Headache or migraine
• Allergic reaction to the anesthetic

These could happen during or after injection and the procedure itself.

After your procedure, you will head to the recovery room and wait for the numbing effect to wear off. You will be closely monitored by nurses and staff to ensure there are no negative reactions. How long you stay and if you have to stay overnight depends on the procedure you received.

When you're cleared, you will be able to go home and continue recovery there. It's completely normal to still feel fatigued, numbness around the injection site, nauseous, and cold as you recover for the next couple of hours and into the next day post-procedure.

Do not drive for at least 24 hours after your procedure; arrange for someone to drive you home from the hospital or outpatient center. Take over-the-counter pain medication or any prescription medications as instructed by your surgeon, and be sure to ask them when you can return to your normal daily activities, as this differs by procedure and by age and health. Drink plenty of water and continue to go to all follow-up visits with your provider. If you need a procedure done, reach out to our skilled, award-winning physicians at Resurgens. Schedule an appointment today to get the process started.