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Regional Anaesthesia

In regional anaesthesia, pain perception is switched off in the body region to be operated upon. The patient feels no pain and is more or less awake, depending on whether he or she wishes to receive a sedative. Regional anaesthesia is commonly used for pain relief in combination with general anaesthesia  in children.

Methods of regional anaesthesia include spinal and epidural anaesthesia, with or without a spinal catheter to allow repeated drug administration, and anaesthesia of the nerve plexus in a single arm or leg, also with or without a catheter. A small amount of local anaesthetic is initially injected into the skin, so that the needle puncture is usually painless. The nerve pathways are then temporarily blocked by injection of the anaesthetic drug. In the rare case that the regional anaesthetic is not sufficient for the surgical procedure, it can be supplemented with analgesics or even general anaesthesia.

Respiration is monitored continuously, but generally requires no assistance. Supplemental oxygen may be given via a nasal cannula as needed.

The circulation is also monitored continuously, and supported by IV fluids or medications if needed. Patients routinely receive small amounts of IV saline infusion.

Anesthetic Risks

• Low blood pressure
  This can occur due to rapid enlargement of the blood vessels from the anaesthetic, and can promptly be corrected by certain medications. It is sometimes associated with dizziness or nausea, which also disappear rapidly.

• Headache
  This is sometimes caused by loss of spinal fluid, occurs several hours to several days after spinal aneasthesia, and generally disappears when the patient lies flat and takes plenty of liquids.
   
• Urinary retention
  Delayed bladder emptying may occur due to paralysis of the nerve supply to the bladder. This generally recovers within a few hours, and recovery can be accelerated by medications. Only rarely is a bladder catheter necessary. 

• Nerve damage
  Irritation or injury to nerves by the injection needle, local bleeding, or infection manifests in the first few hours or days after the anaesthetic. The latter two are more likely when coagulation is abnormal or infection is present, and must be surgically corrected as quickly as possible. This is a rare complication.

• Allergy
  Allergy to drugs or contact with products containing latex can lead to swelling of membranes and difficulty breathing. It is recognised and treated promptly, and occurs only rarely.