Regional Anesthesia and Acute Pain Management
Improving Your Recovery
You and your surgeon may have already discussed some of the options you have available for types of anesthesia for your scheduled procedure, which include general anesthesia, local anesthesia, regional anesthesia or a combination of these. This important decision depends on your own preferences, your surgeon’s preferences, and what your anesthesiologist recommends, as well.
Regional Anesthesia explained:
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 often a good option to consider. Simply put, regional anesthesia is the process of putting a part of your body (a “region”) to sleep by using numbing medicine injected through a needle. In many cases, numbing medicines can also be given through a catheter (a tiny tube positioned next to nerves) for several days. In this case, physicians of the Regional Anesthesia and Acute Pain Management (RAAPM) Team will visit you after surgery to help your surgeon control your pain. Most patients prefer that regional anesthesia be combined in the operating room (OR) with medicines (sedation) given through an IV to provide relaxation and sleep. This sedation is almost always started before we place any needles.
For certain surgeries, instead of regional anesthesia with IV sedation, regional anesthesia is combined with unconsciousness (general anesthesia) followed by a breathing tube placement (if required) when you are in the OR. The regional anesthesia in this situation is used primarily to provide pain relief after surgery if requested by your surgeon.
Finally, for some other surgeries or specific medical conditions, it is best to avoid certain types, or even any kind of regional anesthesia. This decision will be confirmed with you on the day of surgery.
As with any type of surgical or medical treatment, side effects of regional anesthesia are possible. These include incomplete pain relief, soreness or bruising at the needle site, or tingling or weakness that may last for a few days, but rarely can last for weeks or months. Spinals and epidurals can cause headaches about 1% of the time. Serious complications are fortunately very rare and are similar to those resulting from the surgery: injury from infection, injury from bleeding, or injury to a nerve.
Regional anesthesia is often included as a part of “Enhanced Recovery After Surgery” (ERAS) protocols due to some proven benefits which include:
- Better pain relief
- Less opioid use
- Earlier mobility
- Less nausea
- Better bowel function
- Less blood loss and less risk of blood clots (for some surgeries)