Regional anaesthesia

What is regional anaesthesia?

Regional anaesthesia is a type of anaesthesia in which a large part of the body is made completely numb, for example, an arm or the lower half of the body. You remain awake and conscious while under regional anaesthesia, but can feel no pain while the surgeon carries out the procedure.

It also relaxes the muscles in the affected part of the body, enabling the surgeon to do a better job.

Are there different types of regional anaesthesia?

There are several different types of regional anaesthesia. One of the most common types is spinal anaesthesia. This is when the anaesthetic is injected into the spinal fluid sac in the lower back, which numbs the lower half of the body for a few hours. Epidurals are a similar form of regional anaesthesia, in which the anaesthetic is injected just outside the spinal fluid sac.

Another type of regional anaesthesia is a nerve block. This is when the anaesthetic is injected near a nerve or cluster of nerves that are connected to a large part of the body. The anaesthetic blocks these nerves from sending pain signals to the brain, resulting in the affected part of the body feeling completely numb to the patient.
 

What are the side effects of regional anaesthesia?

Regional anaesthesia can cause several side effects:

Pain or bruising around the point where the anaesthetic was administered.  A pins and needles sensation in the part of the body that was made numb is also common. Headaches Difficulty passing urine A drop in blood pressure

In very rare cases, regional anaesthesia can provoke serious side effects, including stroke, heart attacks, nerve damage or death.

How is regional anaesthetic administered?

Before administering a regional anaesthetic, the patient will usually be fitted with a mask that will deliver oxygen to them during the procedure. The anaesthetist will apply a local anaesthetic to prepare the area of the body that will receive the regional anaesthetic (for example, the lower back).

During an epidural, a tiny catheter is inserted into the spine, just outside the spinal fluid sac. The regional anaesthetic is delivered through this catheter. The catheter can stay in the back for several hours or even days, and continues to deliver the anaesthetic.

During a spinal anaesthesia procedure, the anaesthetic is delivered with a needle directly into the spinal fluid sac. This needle is then removed, and there is no catheter left in your spine.

Sometimes patients are offered a sedative as well as regional anaesthesia. This can help them to relax and even drift off to sleep, although it is not the same as the complete unconsciousness that happens when put under general anaesthesia.

What is an anaesthetist?

An anaesthetist is a medical professional who specialises in the administration of anaesthetics. They assess the patient before surgery to determine how much anaesthetic needs to be administered. The amount varies based on several factors, such as the patient’s fitness, BMI, and history of substance use.

If the patient is under general anaesthesia, the anaesthetist will monitor the patient and continue to administer the anaesthetic, ensuring they remain unconscious and aren’t experiencing any pain for the remainder of the surgery.

During smaller operations, the anaesthetist administers a regional anaesthetic to a small cluster of nerves or to the spine, which ensures that the patient experiences no pain during the surgery.

How long does regional anaesthesia last?

Regional anaesthesia usually lasts anywhere from 2 to 24 hours. This depends on the amount of anaesthetic required to keep the patient numb for the duration of the surgery.

What are the advantages of regional anaesthesia over general or local anaesthetic?

Generally, regional anaesthesia is preferred to general anaesthesia as it has a lower risk of side effects and complications. General anaesthesia comes with a higher risk of infection, blood clots, blood loss and postoperative pain.  

What procedures usually require regional anaesthesia?

Regional anaesthesia is often used for orthopaedic surgery, such as elbow or knee surgery. These surgeries require large parts of the body to be completely numb to ensure the patient experiences no pain.

Regional anaesthesia is also used during labour, especially if the mother is experiencing severe pain. It is also usually used for Caesarean sections.

It is also often used during gynaecological procedures, male reproductive surgery, or surgery on the bladder or urinary tract.