Regional Anesthesia
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Regional Anesthesia

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Definition

Regional anesthesia is a type of anesthesia that works by blocking pain to part of the body without causing the patient to lose consciousness. In regional anesthesia, pain-blocking drugs are injected into the areas around the spinal cord or around the nerves that supply a specific region of the body.

Parts of the Body Involved

Regional anesthesia can be used to block pain from various body regions, including the oral-maxillary area (mouth-jaw), chest, abdomen, pelvis, and extremities (arms and legs).

Reasons for Procedure

Regional anesthesia is used to make the body numb for surgery. This type of anesthesia is often used in high-risk surgical patients, though not limited to high-risk patients only, since it is safer than general anesthesia . Regional anesthesia has been proven beneficial in trauma , peri-operation and post-operation, and acute and chronic medical disease and pain states. One type of regional anesthesia, epidural anesthesia , is often used during childbirth. Regional anesthesia has been shown to facilitate early mobilization, increase limb vascularity, and increases duration of pain relief.

Anesthesia Injection into Spinal Canal—Epidural

Epidural Injection

© 2008 Nucleus Medical Art, Inc.

Risk Factors for Complications During the Procedure

  • Current or past health problems
  • Taking medications, supplements, or herbal remedies, blood thinners
  • Allergies (eg, food allergies, medication allergies, latex allergies)
  • Smoking
  • Drinking alcohol
  • Taking recreational drugs
  • Personal or family history of adverse reactions to anesthesia

What to Expect

Prior to Procedure

Your doctor will likely do the following:

  • Physical exam
  • Arrange for you to meet with an anesthesiologist, who will ask about your health and medications, and measure your height and weight

In the days leading up to your procedure:

  • Fast the night before, if recommended by your doctor.
  • Take medications prescribed by your doctor.
  • Avoid certain medications, if recommended by your doctor.
  • Arrange to have someone drive you to and from the procedure, and for help at home after your procedure.

Description of the Procedure

In regional anesthesia, you may remain awake, but you will usually be given a sedative. Prior to administering the anesthesia:

  • Your doctor may set up monitors to track your vital signs.
  • The area to be injected will be cleaned with an antiseptic solution.
  • A local anesthetic may be applied to the skin or injected.

Your anesthesiologist will inject medication near a cluster of nerves that supply the area of your body that requires surgery.

Types of regional anesthesia include epidural and spinal, which both involve injecting medications in or near the spinal canal.

Another type of regional anesthesia, a peripheral nerve block, is often used for knee, shoulder, or arm surgery, and involves injecting medications near clusters of nerves that feed extremities.

Cervical Nerve Block

Cervical nerve block

© 2008 Nucleus Medical Art, Inc.

After Procedure

Your doctor will apply ointment and possibly a bandage to your eyes if you received regional anesthesia involving your eyes.

How Long Will It Take?

Regional anesthesia typically lasts for 2-6 hours.

Will It Hurt?

Depending on whether sedation or local anesthesia is used, you may feel slight pain or tingling with the injection, but the anesthetic will prevent you from feeling pain during your surgical procedure.

Possible Complications

  • Pain and tenderness around the injection site
  • Bruising, infection, or bleeding of the injection site
  • Hematoma (a mass of clotted blood that forms in a tissue, organ, or body space as a result of a broken blood vessel)
  • Spinal headache (a severe headache that may occur after spinal or epidural anesthesia)
  • Decrease in blood pressure
  • Nerve damage
  • Medication mistakenly injected into a vein; symptoms include dizziness, rapid heartbeat, and funny taste or numbness around the mouth
  • Horner's syndrome (change of pupil size on one side)
  • Ptosis (drooping of the eyelid)
  • Pneumothorax (air trapped between the lung and rib cage)

Average Hospital Stay

Your hospital stay will depend on your procedure.

Postoperative Care

Your postoperative care will depend on the nature of your surgery. Most likely, you will receive instructions about limits on your diet and activities.

Outcome

Once the anesthesia wears off, sensation will return to the region where pain was blocked. You may have to restrict activities such as driving, since you may feel numb or drowsy as your anesthetic and/or sedative wears off.

Call Your Doctor If Any of the Following Occurs

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, or discharge from the injection site
  • Tingling, numbness, or trouble moving around the affected area
  • Headache
  • Persistent coughing
  • Chest pain
  • Trouble breathing or shortness of breath
  • Dizziness
  • Heartbeat abnormalities
  • Funny taste or numbness of the mouth
  • Other worrisome symptoms

RESOURCES:

American Association of Nurse Anesthetists
http://www.aana.com

American Society of Anesthesiologists
http://www.asahq.org

CANADIAN RESOURCES:

Canadian Anesthesiologists' Society
http://www.cas.ca

Health Canada
http://www.hc-sc.gc.ca/index_e.html

References:

Anesthesia and heart disease. American Heart Association website. Available at: http://www.americanheart.org/presenter.jhtml?identifier=4462. Accessed April 17, 2007.

Anesthesia basics. Nemours Foundation website. Available at: http://kidshealth.org/teen/your_body/medical_care/anesthesia_basics.html .
Accessed April 17, 2007.

Patient info. American Society of Regional Anesthesia and Pain Medicine website. Available at: http://www.asra.com/patient-info/index.html#C. Accessed April 17, 2007.

Waldman SD. Interventional Pain Management . WB Saunders Company: Philadelphia, PA; 2001.



Last reviewed March 2008 by Ronald Nath, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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