When is regional anesthesia used

Spinal or epidural blocks are examples of regional anesthesia. They are injected near the spinal canal to block sensations in the lower body or limbs. Regional anesthesia is different from general anesthesia, which works on the entire body, not just the surgery site, and the patient sleeps through surgery. It differs from local anesthesia in that a larger region of the body is numbed. One benefit of a regional anesthetic is the patient can be consciously sedated or be fully conscious.

A C-section is an example of a procedure performed with the patient awake, with regional anesthesia epidural used to control the pain of the surgery. The patient can feel things above the abdomen, and she is able to carry on a conversation and see her newborn immediately after birth. By using regional anesthesia, the baby's exposure to sedating drugs is lessened.

Epidurals and other types of regional anesthesia are typically provided by an anesthesiologist or a nurse anesthetist CRNA. Depending on the need, the anesthesia may be given with a needle or a needle may be used to insert a flexible catheter line through which anesthetics and other medications can be administered as needed.

Regional anesthesia is provided by injecting specific sites with a numbing medication that works on the nerves of the body, causing numbness below the injection site. If you are having hand surgery, your anesthesia may numb your entire arm and hand, or the numbness may be mostly limited to your hand. Epidurals or spinal blocks are given on your back.

Epidurals will provide continuous pain relief as long as medications are continuously running and the patient is not having any other side effects. Spinal blocks are given with a needle to the spinal sac, with the medication entering the cerebrospinal fluid.

It uses a finer needle than an epidural. A peripheral nerve block may be given in the shoulder-arm, back, or leg regions. By choosing the site, different levels of the limb may be numbed.

For regional anesthesia, the anesthetic is injected close to a nerve, a bundle of nerves, or the spinal cord. Skill and experience are needed for the anesthesia specialist to inject the anesthetic at the proper location, because the site of injection of the anesthetic has a significant impact on its effect.

Careful technique is needed to reduce the risk of rare complications, such as infection or nerve damage. The site of the injection also strongly affects how quickly the anesthetic is absorbed into the rest of the body.

People who receive regional anesthesia are carefully watched, because the anesthetics used may affect the central nervous system , cardiovascular system, and respiratory system airway and lungs. This is particularly important with spinal and epidural anesthesia, because they may affect blood pressure, breathing, heartbeat, and other vital functions.

Regional anesthesia may be given with other medicines that make you relaxed or sleepy sedatives or relieve pain analgesics. These other medicines are given through a vein intravenously, IV. For regional anesthesia, an anesthetic is injected close to a nerve, a bundle of nerves, or the spinal cord. In rare cases, nerve damage can cause persistent numbness, weakness, or pain.

Regional anesthesia also carries the risk of systemic toxicity if the anesthetic is absorbed through the bloodstream into the body. Other complications include heart or lung problems, and infection, swelling, or bruising hematoma at the injection site. Spinal anesthesia medicine is injected into the fluid that surrounds the spinal cord cerebrospinal fluid. The most common complication of spinal anesthesia is a headache caused by leaking of this fluid.

It is more common in younger people. The local anesthetic numbs the hand and arm. The surgery can be completed during the duration of action of the anesthetic and as long as the patient can tolerate the tourniquet on the upper arm. The tourniquet can be released after about 30 minutes, but many of us think it is safer to leave it inflated as long as is tolerated.

Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency. I'm not sure how much I want to be awake during surgery! I have had blocks that numbed the area, and then I was given enough of a sedative to keep me from caring what happened. But I don't like the idea of hearing all the sound effects - especially if one of them is someone saying, "Oops!

As always, this is such an outstanding hub - you pack so many terrific details into your hubs! Voted up and up!!! Oh you bet I'm hooked now. Gonna take me forever to read all the posts you've written! I really wish there was more information out there like this, aimed at educating the patient but coming from the physician, rather than google. Not to diminish the value of the internet, but this is just a different caliber of information. So often as the patient you would think you would be more informed going into things, but you really aren't and in reality should be.

Not a matter of pointing fingers. I know lots of people who are patients and just assume to not be informed. But for those of us who would like to be, there should be reliable sources of information available, such as this, in which to gather the necessary knowledge you're going to need to be successful as the patient or caregiver.

I know of several people that I am going to forward a couple of your posts to. No soap box I promise, in a round-a-bout way I guess that's a big compliment to you! It really does matter. It's obvious people are reading and there is a huge need for this. Not for self-diagnosis but for self-education. Hooray for recognizing that and spear-heading what appears to be first venture Thanks again, I'll def keep reading.

Comments like yours, Sumer, are the reason I started writing in the first place! Thank you so much for coming back to comment, reading my stuff AND making me smile today by letting me know it matters :. Oh my, where was that before I had surgery! LOL that would have made the preparation a lot easier.

I classically fell into most of those 'side-effects' or what to expect. The smaller pupil thing totally freaked my mom out and the breathing thing almost did me in until I figured out the less I panicked the better of I was. Live and learn.

Certainly wouldn't deter me from recommending it to someone else, I think I am just someone who benefits from knowing more info up front rather than being surprised in a drugged stupor : I also agree. I doubt the anesthesiologist who was different than my surgery anesthesiologist, actually knew of my breathing symptoms afterwards. The post op nurse did but just kept telling us it wasn't anything to be concerned with, normal.

Regardless, awesome hubs. Have started looking through some of your other ones already and I absolutely adore the format! Very informative, and I feel like I'm walking away going, well that explains it!

Thanks for all the hard work and effort that I can only imagine goes into these not to mention your profession alone. As a patient several times over, every member is vital but you're probably one of the members we get to thank the least Glad you liked your block mostly!

I actually have a whole hub about interscalene blocks and talk about the feeling of not being able to breathe. It happens more, I think, than most anesthesiologists realize not reported as often as they occur and not everything the surgeons hear about is passed on to us.

So thanks for the feedback on the hub AND the block! Great post. I also had an interscalene block for shoulder surgery. Took a lot of pre-meds to stop the fidgeting in order to get it in due to the nervousness, but it was glorious after the surgery at least until it was gone! My only issue was I had a little panic after the surgery bc I felt like I had a hard time breathing.