These types of anaesthetic use “local anaesthetic” drugs to numb only the part of your body being operated on. These drugs are similar to those used by a dentist to numb your mouth for fillings or extractions.

The main advantages are reduced pain after surgery and avoiding the side effects of General Anaesthetics, for those who can’t tolerate them.

Regional Anaesthetics are very safe, and with the help of your Anaesthetist, a choice can be made which will improve your comfort and reduce any risks.

Regional anaesthesia can be used in many different parts of your body, your arms and your feet. They may be combined with General Anaesthesia or Sedation. You do not have to be awake during your surgery, although sometimes it is better to stay awake e.g. Caesarean Sections where most mothers prefer to stay awake as they can see their baby being delivered and hold and cuddle the newborn straight away.

Epidural anaesthesia results in the absence of most sensation and pain in part of the body for a short time and temporarily produces loss of movement of the legs.

After numbing the area with local anaesthetic, your Anaesthetist, under sterile conditions, inserts an epidural needle in your back. If the epidural is needed for more than a few hours a thin tube (catheter) is put through the needle into the epidural space, before it is removed.

Epidural anaesthesia is most often used when you are having surgery on your legs or the lower half of your body. It can be topped-up to provide pain relief after your surgery.

When the epidural is used for pain relief after surgery, different drugs are used so that you have better mobility and can cough more easily. This pain relief causes minimal sedation and can be used for 3 days, sometimes even longer.

Spinal anaesthesia is similar to epidural anaesthesia but works more quickly and tends to make you more numb – with a smaller total dose of drugs and a much thinner needle.

A small volume of local anaesthetic is injected directly into the fluid that bathes the nerves in the lower part of your spine. The needle is removed as soon as the injection is done. Surgery can usually start within a few minutes.

A very small dose of morphine is sometimes added to the spinal block. This improves the quality of the anaesthetic and provides postoperative pain relief. The pain relief is produced with little or no drowsiness and may last 24 hours. Occasionally, pain relief may not last 24 hours and other means of pain relief can be used.

Spinal anaesthesia may be combined with general anaesthesia, sedation or epidural anaesthesia. You do not have to be awake during your surgery, although sometimes it is better to stay awake (e.g. Caesarean Section).

Tell your Anaesthetist if:

• Your blood does not clot properly or you bruise easily
• You have a bad infection (e.g. abscess or a boil) or you have a fever
• You are frightened to have a needle put in your back (or anywhere else!)
• You have been put off this type of anaesthetic by stories you have heard
• You are allergic to anything

If you have surgery with epidural or spinal anaesthesia you may experience:

• A tugging or pulling sensation in the area being operated on
• A change in breathing or coughing
• Nausea
• Shivering
• Itching

Other types of regional anaesthetic are less reliable than epidural and spinal and may need to be supplemented with additional injections, sedation or general anaesthesia.

• Your blood pressure may drop, which can make you feel faint until it is corrected
• A sensation of pain which may require conversion to general anaesthetic
• Mild tenderness at the needle site can last for two or three days
• A severe headache occurs in around 1 in 300 cases and can be easily treated
• The local anaesthetic can cause temporary arm weakness or a feeling of breathing difficulty, and rarely a loss of consciousness
• Minor nerve injuries rarely occur and may cause pain or slight numbness for a few days or weeks after the anaesthetic
• Major nerve injury, paraplegia or death is extremely rare

Your anaesthetist can help with these problems.

Your Doctor will be able to give you some advice about the procedure and choice of anaesthetic.