Choosing Regional Anesthesia

Choosing Regional Anesthesia to Improve Your Recovery from Surgery

Your surgeon may have already discussed with you some of the options you have available for types of anesthesia: general, local, or regional anesthesia. This decision depends on what you want, what your anesthesiologist recommends, and what your surgeon wants. If your surgery involves your arm (shoulder and down), your leg (hip and down), or an incision in your chest or abdomen, regional anesthesia is usually a good option to consider.  Regional anesthesia is part of our routine at Wake Forest University Baptist Medical Center. Hundreds of our patients benefit from regional anesthesia every month. Simply put, regional anesthesia is putting a part of your body to sleep by using numbing medicine injected through a needle. In many cases numbing medicines can also be given by a catheter for several days. In this case, physicians of the Regional Anesthesia and Acute Pain Management Team will visit you after surgery to help your surgeon prevent pain. Most patients prefer that regional anesthesia be combined in the OR with medicines given through an i.v. to provide relaxation and sleep. This is why it is our routine to begin giving i.v. medicines even before the OR and even before we place any needles.

For some surgeries, regional anesthesia must be combined with deep unconsciousness followed by a breathing tube placed while you are unconscious in the OR. There are other surgeries, medical conditions, or surgeon requests where it is better to avoid some types of regional anesthesia or to use only general anesthesia. As with any type of surgical or medical treatment, side effects are possible. For regional anesthesia, these are incomplete pain relief, soreness or bruising at the needle site, or tingling that lasts for days. Spinals and epidurals can cause headaches about 1% of the time. Serious complications are fortunately very rare and are similar to those from the surgery: injury from infection, injury from bleeding, or injury to a nerve.

Top

The Three Types of Regional Anesthesia

Peripheral Nerve Blocks: A needle or catheter is placed along the path of nerves to your arm or leg. Numbing medicine is injected to provide 4-20 hours of pain relief. If a peripheral nerve block catheter is used, numbing medicine are given continuously to prevent pain for days— plus you will have a button to safely give yourself more numbing as you need it. Always, you will have back-up pain medicines available by mouth or your i.v.

Epidurals: A needle is placed between the bones of the back for injection of pain relieving medicines. Sometimes, epidural pain medicine specially formulated to last two days is injected through this needle. Other times, a better choice is a small catheter left in place. Then, continuous numbing and pain relieving medicines given through this epidural catheter (along with a button for extra doses) will help prevent pain. In either case, you can lie, sit and usually walk with an epidural. Commonly, we use this catheter for several days during your recovery--usually until you are able to take pills to easily control pain.

Spinals: A thin needle is placed between the bones of your back, and a single injection of numbing medicines is made to numb both legs. We choose spinal medicines so they last from 1 to 8 hours, depending on the predicted length of your surgery and your recovery plans. your recovery plans.

Top

Choosing Regional Anesthesia (pdf)

Anesthesia Risk Disclosure (pdf)

Especially good explanations of regional anesthesia may be found at the following sites:

Hospital for Special Surgery (www.hssanes.org/for-patients)
Mayo Clinic (www.mayoclinic.com/health/anesthesia/SC00026)
Captial Anesthesiology Association (www.capanes.com/services_ra.html)
Stryker Corporation (www.stryker.com/en-us/patients/index.htm)
ABC News OnCall+ Pain Management (www.abcnews.go.com/health/painmanagement/)

 

Top