What is Regional Anesthesia?
Regional anesthesia is a type of anesthesia that can numb one or more nerves. There are several modalities of regional anesthesia, depending on the type of procedure you need. Peripheral nerve blocks can numb one or more nerves to provide anesthesia to a specific region of the body, such as a limb. Epidural and spinal blocks are anesthesia administered directly on the spinal cord.
Am I Awake During Regional Anesthesia?
Regional anesthesia can be used with or without general anesthesia or sedation. It will depend on the procedure and the reason for the procedure to determine if you will need any sedation. By itself, regional anesthesia does not require any additional breathing devices, such as ventilation with an endotracheal tube. However, physicians are now using regional and general anesthesia for many procedures that traditionally only used general anesthesia. This is to provide better comfort for the patient and limit the amount of narcotic pain medication.
How Do You Prepare for Regional Anesthesia?
The type of regional anesthesia will depend on what procedure you are having, and any preparations for that particular procedure will cover all preparations necessary for regional anesthesia as well. If you receive any sedation or general anesthesia, you will be asked not to eat after midnight before your procedure.
What Should You Expect When Getting an Epidural or Spinal Block?
When you get to the hospital or facility where you will have your procedure done, you will first be asked to undress and put on a surgical gown. You may have some labs drawn, and a blood pressure cuff will be applied. You will likely be transferred for the catheter placement to another room or all non-essential health care workers will be asked to leave the room during the procedure.
The procedure will be done with you in an upright sitting position or on your side. First, you will have your back cleaned with an antiseptic soap and then draped sterilely. You may have some local anesthesia injected at the site of the catheter placement. Next, a needle will be advanced into your spinal column. Typically, for a spinal block, you will have a one-time injection of medication into your spinal column. For an epidural nerve block, a catheter will be placed in your epidural space. You may notice part of your body going numb. The duration will depend on how much medication you receive or how long your catheter remains inside your epidural space.
Afterward, you may resume preparation for the procedure, including receiving anesthesia. If no other procedures are planned immediately, you may have family come back to see you. If your anesthesia involves the area near your bladder, you may have a urinary catheter placed to allow your bladder to drain, as the anesthesia may prevent you from urinating.
What Should You Expect When Getting a Peripheral Nerve Block?
When you get to the hospital or facility where you will have your procedure, you will be asked to undress and put on a surgical gown. Next, you may have some labs drawn, and a blood pressure cuff will be applied. Before you have the block performed, you will likely be transferred to another room or all non-essential health care workers will be asked to leave the room. Next, the area that will be anesthetized will be cleaned with an antiseptic soap and then draped sterilely.
The person providing the block may use an ultrasound machine to help identify the nerve or nerves that need to be anesthetized. If so, you may feel some cold ultrasound gel applied to your skin. Once the area is identified, you will feel local anesthesia injected into the skin, and then a deeper needle will anesthetize the nerve or nerves. Occasionally, a peripheral nerve block may have a catheter placed for longer-lasting relief. You may be sent home with this device and given instructions on how to take care of it.
What Should You Expect with Regional Anesthesia?
The aftereffects of regional anesthesia will depend on what type of regional anesthesia you have received and what other procedures you have had. The pain-relieving effects of a regional block usually last under 12 hours, but they can last 72 hours or more in certain circumstances. This will result in good pain relief, but keep in mind that any area with surgery requires care to prevent any injury. In addition, depending on which nerves are anesthetized, you may have some limited function in that area, such as a limb. Your physician will inform you about any possible side effects with any area that is anesthetized.
With an epidural or a spinal block, you will be monitored to ensure you are able to walk and urinate without difficulty.
What Are the Side Effects of Regional Anesthesia?
There are few side effects of getting regional anesthesia. Whenever undergoing any procedure, make sure to inform the physician of all medication allergies, medical conditions, and medications you currently take to prevent any drug interactions. Any anesthetized area will remain numb after surgery, so make sure you avoid injuring it inadvertently. You may have some limited function of that area after anesthesia.
Epidural and spinal blocks may cause issues with urinary retention, so make sure to tell your physician if you are having difficulty urinating after the procedure or have gone 8 hours without urinating.
Occasionally, you can get a significant headache due to leaking fluid from your injection site. If this happens, please notify your physician, as you may require a blood patch to stop the leaking.
While exceedingly rare, bleeding and infection can be caused by epidural catheters or spinal anesthesia, so be sure to tell your physician if you notice any increasing weakness or fevers.
Overall, regional anesthesia is a safe and effective way to help with pain management related to surgical procedures.
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