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Regional Anesthesia
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Frequently Asked Questions about Regional Anesthesia

The most notable benefit is significantly better pain control after surgery.  This is achieved with only minimal use of systemic opioids (narcotics), which has the benefit of decreasing your chances of nausea, constipation, minimizing sedation after surgery, and decreasing exposure to a potentially addictive medication.  A regional anesthetic also allows for easier participation in physical therapy after your procedure.  In abdominal surgeries, use of a regional technique for postoperative pain control has been shown to provide earlier return of bowel function and a quicker recovery.
As with any medical intervention, yes, there are risks associated with a regional anesthetic, however, they are extremely rare.  The risks differ depending on the different nerve block you receive, but generally, they include a risk of infection, uncontrollable bleeding, potential nerve damage, local anesthetic toxicity, and an incomplete block. Additional risks associated specifically with a spinal and epidural are a risk of hematoma leading to spinal cord compression and a risk of a post-dural puncture headache.   Once again, these risks are very rare, and more often than not, the benefits of regional anesthesia outweigh these risks.  If you have any concerns, be sure to have a thorough discussion with your anesthesiologist prior to your procedure.
Absolutely not.  A regional technique may be advised by your surgeon and anesthesiologist, but if you do not feel comfortable having a regional anesthetic, there are alternatives to provide you anesthesia for your procedure and other ways we can treat your pain both during and after surgery.
Per the American Society of Regional Anesthesia and Pain Medicine, nerve injury after a regional block can occur anywhere from 1 in 4,000 to 1 in 200,000 blocks depending on the type of block and specific risk factors.  Your anesthesiologist will discuss risks factor for nerve injury with you based on your specific medical history and procedure.
If you’ve received a nerve block for a procedure on an extremity (shoulder/arm/hand or leg/foot), your block will typically provide pain relief for 12 to 24 hours after surgery.  Occasionally the block may last longer, but it should not last beyond 48 hours.  If this is the case, you should contact your anesthesiologist and/or your surgeon’s office.

As your block starts to wear off, you will first notice that you will be able to move your extremity a bit more purposefully.  You’ll then notice a tingling sensation throughout the area of the block - many describe this sensation as being similar to when your arm/foot “falls asleep.”  At this time, the numbness should begin to resolve, and unfortunately, at this time, you may begin to feel more of the surgical pain.

If you’ve received a spinal block for your surgery, the numbness will last between 2.5 to 3.5 hours.  An epidural block will last as long as there is a continuous infusion of local anesthetic going through the epidural catheter.
Generally, you should begin your pain medication before you go to sleep the evening of your procedure.  Your nerve block may begin to wear off in the middle of the night or early morning, so to avoid waking up in severe pain, it’s advisable to at least begin your pain regimen before going to sleep.  Of course, if your block begins to wear off sooner than that, begin taking the pain medications your surgeon has given you.  There is no danger to starting your pain medications while you have the block in place.
Complications from regional anesthesia vary depending on which block you received.  However, as a general rule, if you have any of the following symptoms, you should contact your anesthesiologist and/or surgeon immediately.
  • Inability to move any part of your arm or leg 48 hours after surgery.
  • Recurrence of tingling, numbness, "clumsiness" in the extremity that was blocked after the initial numbness has resolved.
  • Persistent redness and/or tenderness around needle insertion site.  Purulent drainage at needle insertion site.
  • If you received a spinal or epidural, difficulty moving your legs after the numbness has resolved
  • Persistent, positional headache after you received a spinal or epidural.
Here is a link to the American Society of Regional Anesthesia and Pain Medicine’s website with more information about the different types of anesthesia and regional anesthesia.