Regional Anesthesia & Nerve Blocks

Regional anesthesia numbs a specific part of the body by placing local anesthetic near the nerves that supply it. It includes peripheral nerve blocks — for example, for the shoulder, arm, knee, breast or abdominal wall — and neuraxial techniques such as spinal and epidural anesthesia. A block may serve as the sole anesthetic, or be combined with sedation or general anesthesia.

Ultrasound guidance is one method used to place peripheral nerve blocks. It allows the anesthesiologist to visualize the nerve, the needle and the spread of medication, and for upper- and lower-limb blocks it improves block adequacy compared with the nerve-location techniques studied. The local-anesthetic dose is still selected for the particular block and patient.

For suitable procedures, regional techniques can improve postoperative pain control and reduce the need for opioid pain medicines, and enhanced recovery pathways use procedure-specific multimodal analgesia that may include regional techniques. The duration of pain relief varies with the technique, the medication, the dose and whether a catheter is used. Benefits and side effects depend on the block, the procedure and the individual patient, and the effect on mobility and discharge timing depends on recovery and the facility's discharge criteria.