Local & Regional Anesthesia

Please note that the following guidelines apply to most patients having surgery, but not all of the patients. These are general guidelines only. Specific conditions may require specific needs. Please contact the pre-op nurse or anesthesiologist if you have any questions.

	What is "Local Anesthesia?"
	What is "Regional Anesthesia?"
	What are the advantages ?
	Will I be awake during my surgery or asleep?
	Will I have pain?
	Who will decide which type of anesthesia I will have?
	Will someone stay with me during the entire operation?
	Is it cheaper than general anesthesia ?

What is "Local Anesthesia?"

Having surgery performed under "local anesthesia," involves having local anesthetic drugs (similar to those used by your dentist) injected into tissue to numb a specific portion of the body, usually the area of the body where the surgery will take place. The actual injection may be performed either by the anesthesiologist taking care of you or by your surgeon after a thorough surgical prepping and draping has been performed. The numbed nerves do not allow the "pain signal" from the area being operated on to be sent to your nervous system.

What is "Regional Anesthesia?"

"Regional anesthesia" involves having an injection made near a cluster of nerves to numb the area of your body that requires surgery. This may involve numbing of entire limb, such as an arm or leg, or a whole portion of the body such as half of your neck or the entire lower half of the body. For example, the lower half of the body can be made numb and thus ready for surgery with either an epidural or spinal anesthetic. During spinal or epidural anesthesia, local anesthetic medications are injected in your back near the nerves that are coming from the spinal cord. Similarly, one of your arms can be anesthetized in a variety of ways, either with an injection of local anesthetic above your collarbone or in your armpit. Half of your neck can be made numb with a series of injections in your neck. A portion of your chest can be made numb with injections near your ribs. These are just some of the techniques that an anesthesiologist is trained to perform.

What are the advantages ?

Generally speaking, Local and Regional anesthesia are less intrusive to the body. They tend to affect heart and lung less than the general anesthesia. As a result, the recovery is faster, the side effects are less and there is less likelihood of severe heart or lung problems. Also, these type of anesthesia can provide prolonged pain relief.

Will I be awake during my surgery or asleep?

You may remain awake or you may be given a sedative to help you relax and reduce anxiety. This will be different from "general anesthesia" where you are made totally unconscious and have no awareness or other sensations. With general anesthesia, your entire body is made to fall asleep. The idea with local or regional anesthesia is to keep you sleepy enough so that you are comfortable and can tolerate the procedure while still breathing on your own, but not so sleepy that you lose consciousness and require artificial respiration. If this level of "conscious sedation" is enough for the length of the surgery, your post-operative recovery will probably be smoother and more tolerable. Although many patients have this type of sedation where they remain conscious throughout the surgery, they may still not "remember" much from their experience because of the "amnesia" properties of many of the modern-day sedatives. Therefore, after the surgery, you may think that you had gone to "sleep" yet really only received conscious sedation.

Will I have pain?

Sometimes patients will feel "pulling and tugging" and/or "pressure-like" sensations and this is quite normal. If any true "pain" is felt, the anesthesiologist may elect to give more intravenous medications to help reduce the pain or he or she may inform the surgeon to administer more local anesthetic directly to the surgical site and therefore reduce the pain. Other medications to make you more sleepy and therefore more able to tolerate the surgery may also be added to your "cocktail" through your intravenous line.

Who will decide which type of anesthesia I will have?

After a thorough evaluation of your medical history and laboratory results, your anesthesiologist will exam you and then recommend a plan of action that is best suited to your needs. If the procedure that is being contemplated can be done under local or regional anesthesia, these will probably be the recommended options. Your anesthesiologist will weigh the risks of the various anesthetic options with the potential benefits of each as well as look at your medical condition and the nature of the surgery, and then he or she will make recommendations to you so that you may make an informed decision about what will be done for you. Some surgeries are almost always done under local anesthesia e.g: Pacemaker surgery, Cataract surgery.

Will someone stay with me during the entire operation?

An anesthesiologist (either the anesthesiologist who started your anesthetic care) or one of his or her partners will be with you from the start of your care in the operating room to the time that you are taken to the recovery room. He or she will not only administer anesthesia (either local/regional anesthesia with intravenous sedation or general anesthesia) but also monitor your vital life functions, including breathing, heart rhythm, blood pressure, brain and kidney functions throughout your operation.

Is it cheaper than general anesthesia ?

No, the anesthesiologists fees are generally the same weather you have local, regional or general anesthesia.

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Last modified: May 14, 2003

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