How is regional anaesthesia used?
Regional anaesthesia is used to prevent pain during surgery. It is often used as the only form of anaesthesia, so you remain awake during the operation.
Regional anaesthesia is often combined with sedation so you can relax during the operation. Sometimes, regional anaesthesia is combined with general anaesthesia, usually to achieve good postoperative pain relief.
Types of regional anaesthesia
Depending on the part of the body, this technique has a different name. In addition to an epidural and spinal anaesthesia, which numb the lower part of the body, there are other techniques called peripheral nerve blocks, which make it possible to numb only an arm, a leg or a foot.
Read more about the different types of nerve blocks.
Does getting a nerve block hurt?
Having a block involves using a needle and a syringe to inject the medicine in the right place. Unfortunately, this can be a little uncomfortable. However, the anaesthetist will numb the skin where the needle goes in, so you will feel less discomfort.
Nerves at the level of the arm, groin, leg, etc. are located using mild electrical impulses generated by a nerve stimulator. For several years now, we have been performing the block using ultrasound, which allows the nerve to be found more quickly and accurately and increases your comfort.
When the needle comes close to the nerve, the limb may start to move. This can feel strange, but it usually does not hurt.
Will the block work well enough?
If a sufficient amount of the right medicine is injected in the right place, the block will work well enough. Sometimes it is easy to locate the right place (e.g. a spinal), and sometimes locating a nerve can be difficult (e.g. an interscalene block). It usually takes 15 to 45 minutes before a block works properly.
Commonly performed blocks work in 90–99% of cases, depending on the type of block and the anaesthetist’s expertise.
What if the block does not work?
If a block does not work, there are several options:
- Injecting more local anaesthetic, if possible
- If possible, performing another block
- Improving your comfort with medication
- Switching to general anaesthesia
Recovery after regional anaesthesia
After regional anaesthesia, recovery of nerve function happens gradually; this can take several hours. At some point, you will be able to move the relevant part of your body again, but without feeling anything.
Being able to move does not mean you have regained full strength: before putting weight through the anaesthetised leg or arm, ask a nurse or an anaesthetist for advice.
Possible side effects
In general, regional anaesthesia is safe and has few side effects.
The most unpleasant effect of regional anaesthesia is probably numbness and muscle weakness in the numbed part of the body. This disappears after a few hours.
Side effects usually depend on the type of block. For example, the local anaesthetic may accidentally be injected into a blood vessel or a nerve. This is why the local anaesthetic is always injected slowly, and the technique is always performed by an anaesthetist in an area where oxygen and resuscitation equipment are available.
Nerve damage (loss of function or numbness) can occur due to injury from the needle during regional anaesthesia, or it can be caused by pressure on a nerve during an operation. In most cases, this damage is temporary and recovers within 2 to 3 months.
Why choose regional anaesthesia?
- You avoid the risks and side effects of general anaesthesia, such as nausea and vomiting.
- Regional anaesthesia lasts longer than the surgery, so the pain relief also continues for longer.
- Regional anaesthesia can reduce blood loss.
- Some patients prefer to remain in control.
Why not choose regional anaesthesia?
- In certain circumstances, regional anaesthesia is not suitable for a particular type of procedure. Most operations on the chest and abdomen must be performed under general anaesthesia. However, you may be offered regional anaesthesia for postoperative pain therapy.
- Some patients do not want to be awake during a procedure. However, the anaesthetist can give you light sedation so that you feel very comfortable during the procedure.
- In some circumstances, a regional technique may be uncomfortable for you.