Regional Anaesthesia
What Is Regional Anaesthesia?
Regional anaesthesia involves injecting local anaesthetic near specific nerves to block sensation in a targeted area of the body. It numbs only the part of the body undergoing surgery, allowing you to remain awake or lightly sedated. Regional anaesthesia provides excellent pain relief during and after the procedure and can often reduce the need for strong pain medications postoperatively.
When Is Regional Anaesthesia Used?
Regional anaesthesia is commonly used for:
- Orthopaedic procedures involving the shoulder, arm, hand, hip, knee, foot, or ankle
- Plastic and reconstructive surgery
- Vascular and trauma surgery involving the limbs
- Postoperative pain control — as part of a multimodal analgesia plan
- Patients at risk with general anaesthesia or who prefer to avoid it
It is often used alone or in combination with sedation or general anaesthesia.
How Is Regional Anaesthesia Delivered?
An anaesthesiologist performs the block using precise anatomical knowledge and advanced technology:
- Ultrasound-Guided Technique
A small ultrasound probe is used to visualise the nerves and surrounding structures in real time. - Injection of Local Anaesthetic
A fine needle is inserted near the nerve or nerve bundle, and local anaesthetic is injected to block sensation and movement in that region. - Nerve Block Types
Common blocks include: - Brachial plexus block for shoulder or arm surgery
- Femoral or adductor canal block for knee procedures
- Sciatic or popliteal block for foot and ankle surgery
- Transversus abdominis plane (TAP) block for abdominal surgery
- Catheter Techniques
In some cases, a catheter may be placed to allow continuous local anaesthetic delivery for prolonged pain relief after surgery.
What to Expect Afterwards
After the procedure, the numbed area may feel heavy, tingly, or immobile for several hours. Sensation and movement gradually return as the local anaesthetic wears off. You may be advised to protect the limb during this period to avoid injury.
Many regional blocks provide long-lasting pain relief (6–24 hours) and can significantly reduce the need for opioids after surgery.
Risks and Complications
Common Complications:
- Temporary numbness, weakness, or tingling in the affected limb
- Minor bruising or soreness at the injection site
- Prolonged effect of the block (numbness or weakness lasting longer than expected)
Rare Complications:
- Incomplete or patchy block requiring supplemental anaesthesia
- Nerve irritation or injury (usually temporary)
- Infection or bleeding at the injection site
- Allergic reaction to local anaesthetic
- Accidental injection into blood vessels or spinal fluid
Fasting Guidelines
To ensure your safety under regional anaesthesia, you will need to fast before surgery.
- No Solid Food: Stop eating at least 6 hours before your scheduled procedure.
- Clear Fluids Allowed: You may drink water, clear apple juice, or weak black tea up to 2 hours before surgery. Avoid milk, formula, or juice with pulp.
- Babies and Infants: Fasting instructions vary by age and type of feeding. Please follow the specific instructions provided by your anaesthesiologist.
Medical History and Medications
Before your procedure, your anaesthesiologist will meet with you to:
- Review your medical history and current health status
- Go over your current medications
- Perform a focused examination and discuss the anaesthetic plan with you
Please bring a complete list of medications, including:
- Blood thinners (e.g., Aspirin, Warfarin, Clopidogrel)
- Herbal or homoeopathic supplements (ideally stop 2 weeks before surgery)
- Any recreational substances, smoking habits, or alcohol intake
Pregnancy and Breastfeeding
Let your anaesthesiologist know if you are pregnant, trying to conceive, or breastfeeding, as this may influence anaesthetic choices.