Your Health - Regional Anesthesia

Regional Anesthesia

(Nerve Block)

by Krisha McCoy, MS

Definition

Regional anesthesia is a type of anesthesia. It blocks pain to a part of the body without the patient going to sleep.

Reasons for Procedure

Regional anesthesia is used to make the body numb for surgery:

It may be used with high-risk surgical patients. It is safer for them than general anesthesia.
It has been proven beneficial in trauma, operation related pain, and short and long term medical disease and pain states.
One type, epidural anesthesia, is often used during childbirth to relieve labor pains
It has been shown to help people be mobile sooner after surgery, and increases duration of pain relief.

Anesthesia Injection into Spinal Canal—Epidural

Possible Complications

Complications are rare but no procedure is completely free of risk. If you are planning to have anesthesia, your doctor will review a list of possible complications which may include:

Pain and tenderness around the injection site
Bruising, infection, or bleeding of the injection site
Headache
Decrease in blood pressure
Nerve damage
Medication mistakenly injected into a vein or artery
Damage to organs

Some factors that may increase the risk of complications include:

Current or past health problems
Taking medicines, supplements, herbal remedies, or blood thinners
Allergies
Smoking
Drinking alcohol
Using recreational drugs
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 also go over your history and do a physical examination

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. Also, arrange for help at home after your procedure.

Description of Procedure

In regional anesthesia, you may remain awake, but you will usually be given a sedative to help calm you. 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. This may sting slightly.

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

Types of regional anesthesia include epidural and spinal. 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. The anesthesia is injected near clusters of nerves that feed the arms or legs. A cervical nerve block is a type of peripheral nerve block for surgeries in the neck or arm.

Cervical Nerve Block

After Procedure

If local anesthetic is used, you will slowly gain sensation and motion again in the area that was numbed. It can take a few hours or longer before your sensation is completely back to normal. If treating for pain, the pain will return in a few hours, and the relief may take up to two weeks.

How Long Will It Take?

While the regional anesthesia procedure itself takes several minutes or longer to do, its effects typically last 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. The anesthetic will prevent you from feeling pain during your surgical procedure. You may feel that your limb may be heavy initially and then light later on.

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.

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 sedative wear off.

Call Your Doctor

After arriving home, contact 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 that lasts longer than expected
Pain that you can't control with the medications you've been given
Headache
Persistent coughing
Shortness of breath or chest pain
Dizziness
Heartbeat abnormalities
Funny taste or numbness of the mouth
Other worrisome symptoms

In case of an emergency, CALL 911.

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

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

Mulroy M, Bernards C, McDonald S, Salinas F. A Practical Approach to Regional Anesthesia. Philadelphia, PA: Lippincott Williams & Wilkins; 2008.

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. Philadelphia, PA:WB Saunders Company; 2001.

Last reviewed November 2009 by Zarina G. Memon, 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.