Regional Anesthesia

//Regional Anesthesia

What is regional anesthesia?

Regional anesthesia or “a nerve block” is a form of anesthesia in which only a part (or region) of the body is anesthetized or made numb. Regional anesthesia involves injecting numbing medicine around the peripheral nerves that innervate certain parts of your body.  We perform these nerve blocks so you will have reduced pain after your procedure.

If you are having surgery on your upper extremity (shoulder, hand, etc) you may receive a nerve block above or below your clavicle (collar bone) that will anesthetize only the arm. Surgery on your lower extremity (e.g. hip, knee, foot) may also receive a nerve block.

Nerve blocks have 2 different varieties. We can do a one-time injection that can last ~36 hours with the latest long-lasting numbing medicines. We can also place a small micro catheter near the nerves to continuously drip numbing medicine for 3 days. Deciding between these 2 options will depends on your particular surgery and medical factors. Nerve blocks are usually performed while the patient is sedated and are well tolerated.

Dr. Shiraz is a board certified anesthesiologist who specializes in innovative techniques designed to reduce pain without the use of narcotics. After completing his residency in anesthesiology at Emory University in Atlanta, GA in 2011, he completed a fellowship specialization in regional anesthesia (nerve blocks) and acute pain medicine at Columbia University in New York City. Dr. Shiraz also serves on the Speakers Bearau for Halyard Heath, as well as the Advisory Board for Pacira Pharmaceuticals. He is frequently an instructor at regional anesthesia workshops.

What are the benefits of regional anesthesia?

The benefits are numerous.  In addition to substantially reduced pain after surgery, patients who receive nerve blocks with surgery have less nausea, higher satisfaction scores, less blood loss, and recover more quickly after surgery. There is also a reduced risk of serious medical complications, such as heart attack or stroke.

Is regional anesthesia safe?

Anesthesia, whether general or regional, is extremely safe today due to advances in medical knowledge, the availability of new and safer medications and techniques, as well as technological advances in the monitoring of a patients during and after the surgery. While no technique is completely risk free, the complications and side effects associated with regional anesthesia tend to be of a minor nature such as tenderness and/or bruising at the injection site. Occasionally a nerve block may followed by numbness and tingling in the distribution of the blocked nerve(s) for a limited time following the nerve block. Significant complications associated with regional anesthesia are extremely rare.

How is the nerve block performed, and is it painful?

All blocks are normally performed before you enter the operating room. An intravenous line is inserted, monitors are attached, and your anesthesia team will explain the entire procedure to you and answer any questions you may have. You will then be comfortably sedated and most patients hardly remember the block being performed. Before the block is performed the skin is cleaned with a sterile solution followed by a small skin wheal of local anesthetic at the block needle insertion site. All that you will feel is a small pinch, and usually not much after that.

Will I see, feel, or hear anything in the operating room?

Most patients receive general anesthesia and will be completely asleep during the procedure.   If you would prefer to not have general anesthesia for your procedure, this may be possible depending on can be discussed with your anesthesiologist.

Will I be nauseated during or after the surgery?

It is less likely you will have nausea if you receive a regional anesthesia (nerve block). Because the surgical area will be numb, you will not need very much opioids after surgery for pain.  Opioids can cause nausea, as well as many other harmful side effects.

Will I have pain after the surgery?

Pain is still possible after surgery even with a nerve block.  However, patients tend to have better pain control if they receive nerve blocks, since it is a more targeted approach to your pain.