Regional anesthesiology entails injecting a local anesthetic (numbing medicine) near nerves to numb a portion of the body. There are several types of regional anesthetics including spinal anesthesia, epidural anesthesia and various specific nerve blocks. Regional anesthesia can be used by itself, or combined with sedation or general anesthesia, depending on the surgery and patient’s needs.
Epidural anesthesia involves the injection of a local anesthetic, usually with a narcotic, into the epidural space. The epidural space is outside of the spinal cord. Epidural anesthesia is most often administered via a pump through a small catheter (tube), which allows for a long duration of pain control (the anesthetic does not wear off until the pump is turned off and the catheter removed). This type of anesthesia is commonly used in labor and delivery and for procedures of the lower extremities. Occasionally, we place epidurals for post-operative pain control for extensive abdominal surgeries.
Spinal anesthesia also involves the injection of a local anesthetic, with or without a narcotic, into the fluid that surrounds the spinal cord. This type of anesthesia is commonly used for Cesarean sections, pelvic surgeries, hip and knee replacements, and other procedures of the lower extremities.
Nerve blocks are used to block pain at a specific site. By injecting a local anesthetic into or around a specific nerve or group of nerves, pain relief can be localized to the site of surgery. This type of anesthesia provides pain control during and after a procedure, It is associated with minimal side effects. Examples of nerve blocks include an adductor canal nerve block for knee surgery, an interscalene nerve block for shoulder surgery, and a supraclavicular nerve block for arm and hand surgery.