“Regional anesthesia” refers to anesthetizing only a specific region of the body by blocking the nerve impulses that carry sensory information back to the brain, rendering the body part “numb” or painless. The most common types of regional anesthesia are spinals, epidurals and peripheral nerve blocks placed at large nerves associated with a specific body part. Regional anesthesia is often used in lieu of general anesthesia to circumvent the need to render a patient deeply unconscious. However, patients are typically given IV sedative hypnotic medications in conjunction with regional anesthesia so they can sleep lightly during the surgery and thus wake up quickly without pain or the untoward side effects occasionally associated with general anesthesia.
Do I have to be awake during my surgery?
You may remain awake, or you may be given a sedative. You do not see or feel the actual surgery take place. Your anesthesia provider, after reviewing your individual situation, will discuss the appropriate amount of sedation for you. This sedation is sometimes referred to as “twilight sleep” or “conscious sedation” and describes a semi-conscious state that allows patients to be comfortable during certain surgical procedures.
Will I feel any pain during placement of a nerve block?
Getting a nerve block is no more painful than getting an IV. Your anesthetist will numb the skin before placing the nerve block and can also provide you with mild sedation prior to the procedure.
What are the risks associated with regional anesthesia?
Like any other medical procedure, there are risks associated with regional anesthesia. Complications or side effects can occur, even though the patient is monitored carefully and the anesthesiologist takes special precautions to avoid them. To help prevent a decrease in blood pressure, fluids may be administered intravenously. In rare cases, a headache may develop following the block procedure. By holding as still as possible while the needle is placed, the patient may help to decrease the likelihood of a headache. The area where the nerve block was administered may be sore and tender for a few days. These discomforts, if they do occur, often disappear within a few days. If they do not disappear or become severe, additional treatments are available.
What are the benefits of regional anesthesia?
Frequently, patients experience less nausea from regional blocks, and they generally awaken faster. In addition to providing anesthesia during surgery, regional blocks also can be used to reduce the pain after an operation. Generally, regional nerve blocks and catheters will provide better pain control than intravenous or oral narcotics.
How common is a nerve injury after a regional block?
Nerve injury after a regional block is a rare occurrence, which can occur anywhere from 1 in 4,000 blocks to 1 in 200,000 blocks, depending on the type of block and specific risk factors. It can be related to direct-needle injury of the nerve or to secondary complications like bleeding or infection. To prevent nerve injury, inform the anesthesiologist you experience any sharp or radiating pain during needle placement or injection. If you experience any new symptoms like tingling, numbness or motor dysfunction after a nerve block already has worn off, seek medical attention immediately as this can be a sign of secondary damage by hematoma or infection. Because recovery of nerve function depends on timely diagnosis and treatment, do not take any unexpected changes lightly.
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