Anesthesia means a loss of feeling or inability to feel pain. Regional anesthesia or block is a method of pain prevention in a specific part of the body, such as the hand.
Anyone who undergoes a painful procedure may be a candidate for a regional block. A regional block is sometimes used for surgery in the hand or arm. It can also be used for procedures such as circumcision of the penis and corneal surgery. This type of pain control is not usually used for major operations.
In a regional block, medication is injected around a large nerve or nerves. These nerves give sensation to the site of the procedure. Regional blocks are usually done in an operating room. Unlike local numbing, the medication is injected far away from the procedure site. although regional blocks cause a larger area of the body to be numb than local anesthesia, the medication is the same.
The site of the procedure is first cleaned with an antibacterial cleanser. The local anesthesia is often injected deep into the skin or other surface. This is where the major nerves are usually located. The medication may cause a stinging or burning sensation at first. This discomfort lasts for just a few seconds.
It takes a few minutes for the medication to have its full effect. The person should be unable to feel pain in the area. Regional blocks also paralyze the muscles in the area, unlike local anesthesia. A pressure sensation may be felt when the area is cut or poked with needles. But pain should be absent. If pain is felt, the person should tell the healthcare provider. More medication can be given to control pain.
Sedative medications may be given before and during the procedure, usually through an intravenous line, or IV. This helps the person relax. It also reduces the pain of the initial injections. The numbing medication generally wears off within a few hours of the procedure.
Many procedures that use regional anesthesia are fairly minor. After the procedure, the person is taken to a surgery recovery room. The individual may be able to go home a few hours after the procedure. Someone else must drive the person home. This is because sedatives can impair coordination and reflexes for several hours.
Regional blocks require little or no home care. But the procedure itself may require monitoring and treatment. The procedure usually causes more problems during recovery at home than the medication.
Regional blocks are unlikely to cause complications. Allergic reactions are possible and may cause temporary breathing problems. In rare cases, if the medication is accidentally injected into the bloodstream, or if too much is used, seizures or arrhythmias may occur.
The American Society of Anesthesiologists recently issued a warning about the potential side effects and interactions of herbal remedies with medications used before, during, and after surgery. The group recommends discontinuing the use of all herbal remedies and supplements at least 2 weeks before planned surgery.
Author:Adam Brochert, MD
Editor:Ballenberg, Sally, BS
Reviewer:Eileen McLaughlin, RN, BSN
Anesthesia, 1990, Miller et al.