Regional Anesthesia

Regional anesthesia involves making a portion of the body insensitive to pain by temporarily “blocking” large groups of nerves by the injection of local anesthetics. There are several forms of regional anesthetics, which include:

Spinal/Epidural

Also known as neuraxial anesthesia, a spinal or epidural anesthetic is used for lower abdominal, pelvic, rectal, or lower extremity surgery. This type of anesthetic involves injecting anesthetic medication into the spinal or epidural space, which surrounds the spinal cord. The injection causes numbness in an area of the body supplied by the nerves that are blocked by the anesthetic. Usually, but not always, a spinal anesthetic involves a single injection of a medication, while an epidural anesthetic involves placement of a small catheter (hollow tube). Epidural anesthesia may also be used for the purpose of controlling pain both during and after surgical procedures, including those involving the upper abdomen or chest, or for management of labor pain.

Nerve Block

Nerve block involves the injection of local anesthetic near the location of a nerve or group of nerves that provide sensation to a specific region of the body, usually one of the limbs. Depending on the type of medicine administered, you may expect the affected body part to be numb for up to 24 hours or more after the surgery.
Some examples of surgery which might involve the use of a nerve block are: rotator cuff repair, anterior cruciate ligament (ACL) reconstructions, shoulder surgery as well as many orthopedic fracture repair procedures.
The use of ultrasound-guidance has improved the quality, effectiveness and safety of many nerve blocks.
IV Regional Block

Also known as a Bier Block, an IV regional block is used for surgical procedures of the lower arm or hand. The block involves placement of a tourniquet, similar to a blood pressure cuff, on the upper arm to be blocked, and injection of local anesthetic into an IV placed in the hand or forearm. This type of block is appropriate for surgical procedures lasting less than one hour. In addition to the local anesthetic, you may also receive some form of sedation to keep you comfortable. Possible side effects include infection, convulsions, persistent weakness, numbness or pain, injury to blood vessels, loss of limb, or unconsciousness necessitating general anesthesia.

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