Regional Anesthesia

There are many different techniques that are used in regional anesthesia to help decrease pain after surgery.  These include Epidural anesthesia, Spinal anesthesia, and Peripheral Nerve Blocks.   In all of these procedures, long acting medications are placed either in the epidural space around the spinal cord, within the fluid that bathes the spinal cord, or surrounding the large nerve bundles which supply different regions of the body.  Sometimes this medication is given as a single dose that will last from 3 to 24 hours.  In other cases a small catheter is placed which will infuse medication from a pump into the desired area.  This catheter may be left in place for several days after the surgery to help control pain depending on the surgery.  The value of regional anesthetic techniques is that they often give patients dramatic pain relief after surgery.  In other cases the pain relief may be very good, but when combined with other techniques will be dramatic.  This allows patients to be more mobile, take larger breaths, feel more comfortable and generally recover more rapidly.  Of course there are risks with every procedure and regional anesthesia is no exception.  In general the risks of the procedure are weighed against the average intensity of postoperative pain for a given surgery.  For surgeries which are relatively painful a regional anesthetic technique may be a valuable postoperative adjunct.  If a patient undergoes a regional anesthetic technique they will have an anesthesiologist evaluate them every day that the technique is used.  The dose may be increased or decreased.  Sometimes the technique will be combined with another pain relief technique.  The most common techniques which are combined with a regional technique are a Patient Controlled Analgesia or PCA pump, oral pain meds, IV pain meds.  For more info on these techniques see pain control after surgery.