Regional Anesthesia FAQs

Not all patients or surgical procedures are ideal candidates for regional anesthesia. Please consult your anesthesiologist and surgeon to determine whether or not regional anesthesia is right for you.

What is regional anesthesia?

Regional anesthesia is a targeted type of anesthesia.  It involves injecting numbing medicine around nerves that provide sensation to specific parts of your body (shoulder, arm, leg, foot) and can be used instead of general anesthesia or in addition to general anesthesia as a way to control pain after surgery.

Anesthesiologists can perform these procedures before surgery to prevent pain, or they can provide regional anesthesia as a “rescue” technique to relieve pain in recovery room after surgery. Types of regional anesthesia procedures include peripheral nerve blocks. Depending on the type of local anesthetic used, a nerve block can last any from a few hours to 36 hours.

There are many advantages to regional anesthesia. Because you will have decreased sensation, you need to take less opioid pain medicines even though you will have these medications prescribed to you. Patients who receive regional anesthesia also have less nausea, recover more quickly immediately after surgery, and sleep better overnight compared to patients who do not have regional anesthesia.

Even if you choose regional anesthesia instead of general anesthesia, you don’t have to be “awake” during surgery. Anesthesiologists often combine regional anesthesia with either intravenous sedation or general anesthesia, both of which can allow you to fall asleep during surgery. You should discuss your preferences with your anesthesiologist prior to surgery.

There are always risks associated with performing any procedure. Fortunately, serious complications associated with regional anesthesia are exceedingly rare. Anesthesiology practices that specialize in regional anesthesia commonly have systems in place to prevent complications and treat them quickly if or when they occur.

What can I expect on the day of surgery?

On the day of surgery, you will meet with an anesthesiologist who will evaluate whether or not regional anesthesia is the right option for you. If you are eligible and desire regional anesthesia preoperatively, the anesthesiologist will perform your nerve block approximately 15-30 minutes before your surgery. Nerve blocks may be performed in a specialized pre-operative area outside of the operating room. After your IV is inserted, your anesthesiologist may provide you with sedating medication during the performance of your nerve block. Before the procedure starts, your anesthesiologist will perform a “time-out” with you to confirm your name, date of birth and the correct site and side of your surgical procedure. Anesthesiologists frequently use ultrasound to identify your unique anatomy and safely inject numbing medication around the nerves. After the nerve block, your affected limb will “go to sleep” over the next 5-10 minutes.

What are my regional anesthesia options for hand, wrist, forearm, or elbow surgery?

For hand, wrist, forearm, or elbow surgeries (carpal tunnel release, fracture repair, or tendon transfer) there are a few different locations in which to place the nerve block depending on the site of surgery and expected placement of the tourniquet. Most commonly, the nerve block is performed above the collar bone (supraclavicular block). This type of pain relief reduces your need for opioid pain medications.

What are my regional anesthesia options for upper arm or shoulder surgery?

For surgeries involving the upper arm or shoulder, nerve blocks are most commonly performed in the neck (interscalene block). This type of pain relief reduces your need for opioid pain medications.

What are my regional anesthesia options for knee surgery?

For surgeries involving the knee including total knee replacement, nerve blocks are routinely placed near the groin (femoral nerve block) or on the inside part of the thigh where the nerves to the front of the knee are located (adductor canal block). This type of pain relief will help you perform physical therapy, reduce your need for opioid (narcotic) pain medications, and decrease the time it takes for you to achieve discharge criteria.

It is important to realize that any nerve block may also cause weak muscles. Therefore, after your nerve block, you must realize that you are at increased risk of falling because your leg may not be strong enough to support your weight.

Anesthesiology practices that provide regional anesthesia for pain relief after joint replacement are advised to have a comprehensive fall prevention program in place. However, in the immediate postoperative period it is important to always ask for assistance anytime you need to get out of bed. Do not attempt to walk by yourself.

What are my regional anesthesia options for foot or ankle surgery?

For surgeries involving the foot or ankle, nerve blocks are most commonly performed in the area behind your knee (popliteal fossa block) or at the level of the ankle (ankle block). This type of pain relief reduces your need for opioid pain medications.

How long will the numbness from the local anesthetic medication last?

The intensity and duration of your block largely depends on the type of numbing medicine (local anesthetic) that was used. As a single dose, some local anesthetic medications provide a few hours of numbness while others can provide numbness that lasts up to a day.

Does it hurt to get a nerve block?

Getting a nerve block should not be much more painful than getting an IV. We can also provide you with mild sedation prior to the procedure. Also, using ultrasound to locate the nerves during the procedure minimizes the amount of time to perform the block and the amount of pain that you feel.

Can you put the nerve block in after I’m asleep?

Although any of these procedures can be performed under general anesthesia, doing so prevents you from giving us feedback as we work around your nerves. Placing the nerve block while you are “awake” (but comfortably sedated) adds an additional measure of your feedback and increased level of safety to the procedure.

Is it safe to get a nerve block?

There are always risks associated with performing any procedure. Fortunately, serious complications associated with regional anesthesia are exceedingly rare. Anesthesiology practices that specialize in regional anesthesia commonly have systems in place to prevent complications and treat them quickly if or when they occur. We perform this procedure in a sterile manner to minimize the risk of infection. The possibility of trauma to the nerves exists, but your anesthesiologist may take special precautions, including the use of ultrasound, to decrease this risk. Most commonly, patients report mild bruising or soreness from the site of injection, or minor tingling sensation in the region block for up to a few days.