MGH Orthopaedic Ambulatory Surgery Center Anesthesia Template

Regional Anesthesia

Regional Anesthesia is an anesthetic technique in which a part or area the patient's body is put to sleep using a local anesthetic or numbing medicine. Regional anesthesia is particularly appealing when used for orthopedic surgery because these surgeries involve the extremities (e.g. Shoulder to hand or hip to foot) and may be associated with significant post-operative pain. In addition providing intra-operative pain relief, regional anesthesia can be used provide excellent long lasting post-operative pain relief.

There are several regional options available depending on the type of surgery, location of the surgery, duration of surgery, amount of expected post-operative pain and surgeon preference. (See Anesthetic Options For Your Surgery in the right column).

Simply put, regional anesthesia can be divided into two basic categories. First, peripheral nerve blocks in which local anesthesia or numbing medicine is place next to the nerves that supply the extremity. These blocks provide both good intra-operative pain relief and up to 24 hours of post-operative pain control. These blocks are used primarily for longer surgical procedures and ones in which a large amount of post-operative pain is expected. Secondly, the bier block/IV regional is a short acting regional anesthetic technique in which the local anesthetic is injected into a vein in the extremity. Again the bier block/IV regional provides good intra-operative pain relief However unlike the peripheral nerve block it provides no post-operative pain relief. This technique is used for shorter procedures in which little post-operative pain is anticipated. (For a more detailed description and explanation of a particular regional technique, click on the regional technique in the right column).

Combined with the regional anesthesia, the patient receives either sedation through the intravenous to provide different levels of relaxation and sedation or a light general anesthetic depending on patient and surgeon preference.

Patients can react differently to sedation and regional anesthetics. Therefore, from the moment the patient receives their block until the time the patient is comfortable in the recovery room, a member of the anesthesia care team will be caring for the patient the entire time. This is done to ensure the anesthetic is working perfectly and the patient is calm, comfortable and stable.

As with any anesthetic, there are inherent risks associated with regional anesthesia and fortunately serious complications are extremely rare. Prior to signing your consent the anesthesiologist will ask you if you understand the common and uncommon risks, side effects, and possible complications of the regional anesthesia technique listed on the anesthesia consent form. He or she will also answer any questions you may have.