ESC DURING
The Anesthesia Team
You will meet and discuss your anesthetic plan with the anesthesiologist on the day of your surgery. Typically, the anesthesiologist works with a CRNA, or Certified Registered Nurse Anesthetist, to provide adequate anesthesia, analgesia and amnesia during your surgery. After reviewing your medical history, your anesthesiologist, in consultation with your surgeon, will determine the best type of anesthesia for you, taking your desires into consideration whenever possible.
There are three main categories of anesthesia: general, regional and local. Each has many forms and uses. These options will be discussed during your preoperative interview with the anesthesiologist. 
General Anesthesia involves the total loss of consciousness, pain sensation and protective airway responses. 
Local Anesthesia provides numbness to a small area of the body, such as a dermatologist might use to numb the skin around a mole before removing it. For some surgical procedures, a local anesthetic may be injected into the skin and tissues to numb a specific location. 
Regional Anesthesia involves your anesthesiologist injecting medication near a cluster of nerves to numb only the area of your body that requires surgery. If appropriate, you may be offered a peripheral nerve block to decrease pain after surgery. 

 

Pain Relief After Surgery
Intravenous or IV medicines will be given as needed before, during and after your surgery. These medicines will dull your pain but won’t take the pain away completely. 
Local anesthesia may be injected by your surgeon into the incision to numb a small area.
Regional Nerve Blocks may be offered to help decrease pain after surgery. Local anesthetic drugs are used for these procedures to decrease or “block” sensation over a wider region of the body. 
Often, both general anesthesia and regional anesthesia are combined during the procedure, especially if one of the intentions of the regional technique is to help control pain after surgery. The use of regional anesthesia in addition to general anesthesia may reduce the amount of anesthesia you require. This may lead to a faster recovery. The types of regional anesthesia techniques that are commonly used in combination with general anesthesia are single-shot (one time) injections of nerve blocks and continuous catheters. 
If you receive a single-shot nerve block, you can expect up to 4-24 hours of pain relief after surgery; however, the exact duration of analgesia depends on many factors. For adults, single-shot nerve blocks are a one time injection of local anesthesia given typically under sedation but before general anesthesia is started. Single-shot nerve blocks are often used for pain control after orthopedic (bone and joint) surgery.
In certain types of surgery, it is advantageous to have longer than 24 hours of numbness. In these cases, the anesthesiologist may place a catheter to allow the continuous delivery of local anesthesia. The catheter typically stays in place for 2 days, and you can easily remove it at home. 
 
Side Effects
Any type of pain medicine may cause side effects. In normal doses, narcotics may cause some itching, constipation, nausea, vomiting, or drowsiness. We always recommend you eat something before taking narcotics to decrease the risk of nausea. If you have a block, you will have some difficulty moving the affected limb while the block is working. You will need help getting around and should be cautious to avoid falling or injuring the affected limb since sensation is decreased. As the block wears off, you will begin to notice a tingling sensation and you will regain motor function in the affected limb. Be sure to take your oral pain medicines prior to the block wearing off to prevent uncontrollable pain.