Anesthesia: Regional Anesthesia

Cross section of lower spine with needle inserted just outside sac surrounding spinal cord.

You’re scheduled for surgery. During surgery, you’ll receive medicine called anesthesia to keep you comfortable and pain-free. Your surgeon has decided that you’ll receive regional anesthesia. This sheet tells you what to expect with this type of anesthesia.

What is regional anesthesia?

Regional anesthesia numbs one region of your body. The anesthesia may be given around nerves or into veins in your arms, neck, or legs (nerve block or Bier block). Or it may be sent into the spinal fluid (spinal anesthesia) or into the space just outside the spinal fluid (epidural anesthesia). You may also be given sedatives to help you relax.

Nerve block or Bier block

A small area of the body, such as an arm or leg, can be numbed using a nerve block or Bier block.

  • Nerve block. During a nerve block, your skin is numbed. A needle is then inserted near nerves that serve the area to be numbed. Anesthetic is sent through the needle.

  • IV regional or Bier block. For this type of block, an IV line is put into a vein. The blood flow to the area to be numbed is blocked for a short time. Anesthetic is sent through the IV.

Spinal anesthesia

Spinal anesthesia numbs your body from about the waist down.

  • Anesthetic is injected into the spinal fluid. This is a substance that surrounds the spinal cord in your spinal column. The anesthetic blocks pain traveling from the body to the brain.

  • To receive the anesthetic, your skin is numbed at the injection site on your back.

  • A needle is then inserted into the spinal space. Anesthetic is sent into the spinal fluid through the needle.

Epidural anesthesia

Epidural anesthesia is most commonly used during childbirth and may also be used after surgical procedures of the chest, belly, and legs.

  • Anesthetic is injected into the epidural space. This is just outside the dural sac which contains the spinal fluid.

  • To receive the anesthetic, your skin is numbed at the injection site on your back.

  • A needle is then inserted into the epidural space. Anesthetic is sent into the epidural space through the needle.

  • A small flexible catheter may be attached to the needle and left in place. This allows for continuous injections or infusions of anesthetic.

Anesthesia tools and medicines that might be near you during your procedure

  • Local anesthetic. This medicine is given through a needle numbs one region of your body.

  • Electrocardiography leads (electrodes). These are used to record your heart rate and rhythm.

  • Blood pressure cuff. A cuff is placed on your arm to keep track of your blood pressure.

  • Pulse oximeter. This small clip is placed on the end of the finger. It measures your blood oxygen level.

  • Sedatives. These medicines may be given through an IV. They help to relax you and keep you comfortable. You may stay awake or sleep lightly.

  • Oxygen. You may be given oxygen through a facemask.

Risks and possible complications

Regional anesthesia carries some risks. These include:

  • Nausea and vomiting

  • Headache

  • Backache

  • Decreased blood pressure

  • Allergic reaction to the anesthetic

  • Ongoing numbness (rare)

  • Irregular heartbeat (rare)

  • Cardiac arrest (rare)