Regional Anesthesia For Surgery

What is it?
Regional Anesthesia involves the process of injecting a local anesthetic in an area, which contains a cluster of nerves, in order to render insensate the area needing surgery. Regional anesthesia would include a spinal anesthetic, epidural anesthetic, or the blocking of a particular nerve bundle for a certain extremity or region of your body. An anesthesiologist performs your regional anesthetic, after the placement of monitors such as blood pressure cuff, pulse oximetry, ECG leads, and usually after the administration of a sedative.

Spinal Anesthesia
This is one modality of providing loss of sensation for surgical procedures in the lower part of your body. It entails the sterile placement of a fine needle through a portion of your skin in the lower back, previously anesthetized with local anesthetic. The spinal needle passes in between your lower vertebrae (backbones) to reach the dura (a membrane that contains the cerebrospinal fluid), which surrounds your spinal cord. An adequate amount of local anesthetic, and sometimes a narcotic drug, is administered into this fluid. The needle is then removed. You will feel warmth in your legs and tingling, then loss of sensation. Depending on the drug administered by your anesthesiologist, the spinal anesthetic may last between one hour and five hours. This correlates well with the length of your surgical procedure.

Epidural Anesthesia
Similar to spinal anesthesia this is another way to achieve loss of sensation in the lower aspect of your body. Epidural anesthesia is a technique, which can be used both for intraoperative pain management as well as a way to control your pain after surgery. This technique involves the sterile placement of a small plastic catheter (tube) in your epidural space. The catheter is placed through a needle; the needle is removed after the catheter is in place. The catheter remains in the epidural space, while its external portion is taped to your back. Through this catheter your anesthetic team is able to administer the drug combination needed to give you comfort during the procedure as well as during the beginning period of your recovery.

Local Anesthesia
This is done either by your anesthesiologist or by your surgeon. It involves the administration of a local anesthetic in the tissue around the area to be operated. Comparable to the other regional techniques, under these circumstances, the local anesthetic inhibits the transmission of pain from the area to your brain.

Decisions for type of anesthetic
Each anesthetic provides certain risks and benefits according to the type of surgery you have. We recommend that you discuss these in detail with your anesthesiologist during your pre-operative visit. Level of Alertness during Regional Anesthesia You may wish to receive sedation during your regional anesthetic. We find that the majority of our patients prefer to be comfortably napping while the surgical procedure occurs. The sedation, which you receive during this time, allows you to be able to communicate if you wish; we are able to titrate (regulate) the level of your sedation according to your needs. At the same time, if you prefer to receive no sedation, this also can be done according to your preference.

Recovery from Anesthesia/ The Recovery Room

This is also called the PACU-the Post Anesthesia Care Unit. This is the area where your anesthesiologist and your recovery room nurse provide your needs in further awakening from anesthesia. The team monitors your vital signs, address your pain management needs, and prepare you for the next step in your recovery-either the Phase II or your hospital room. You will stay in the recovery room until the majority of your anesthesia wears off. Most patients spend about one hour in the PACU. However, this is dependent upon the type of surgical procedure that you underwent, your individual response to anesthesia, or the hospital room availability. At our institution some patients may be recovered from anesthesia on the Intensive Care Unit.