Regional Anesthesia Program
One area of pain relief that has become more available and popular is Regional Anesthesia. This type of anesthesia provides pain relief by placing local anesthetics (numbing medicines) near nerves, so that the nerve temporarily stops carrying pain and other sensory signals to the brain. This type of injections is done commonly in the dentist’s office, in the delivery suite for labor pain, and many other places. There are special considerations for doing these injections in children, and a select group of our anesthesiologists has the knowledge and skill to make these injections safe and effective.
Is regional anesthesia right for my child?
Before surgery, our faculty may talk with you about whether a nerve bock or nerve block catheter is right for your child and for their type of surgery. An important thing to tell the doctor is if there is any history of nerve problems: weakness, numbness, tingling. If your child has a problem with easy bruising or bleeding, or infections in the area of surgery, please let us know. The anesthesiologist on the regional anesthesia team will tell you the details of the procedure, what to expect, how long the block will last, and help make a plan for how to treat the pain the will be there when the numbness finally wears off.
How is the nerve block done?
Commonly the nerve blocks are done under general anesthesia especially in younger children. Since the nerves lie deep under the skin, a needle is used to get the medications where it needs to go. We use either ultrasound guidance or a special nerve stimulator to help us find the nerve. If the best thing to do is a one-time injection of medicine, the injection may be done at the end of surgery, so the numbness lasts for the longest amount of time after surgery. If a surgery is one where a catheter (a thin length of tubing that can carry medicine) is a good idea, then a special needle will be used that allows us to insert the catheter next to the nerve. The catheter is carefully secured to the skin, and can remain in place for up to 3 days, with a pump instilling small amounts of medicine near the nerve the whole time.
What happens after surgery?
The numbness of a single injection can last up to a day after surgery. While the body part is numb, extra care will be needed to make sure nothing happens to the area, because it will not have the protection that comes with full sensation and strength (that is a trade-off for not feeling pain). At some point, the pain will start, and additional pain medications will be needed to keep it under control. If a catheter is used, the pain will mostly be controlled for 2-3 days with continuous instillation of numbing medication. Though there will be less pain than with a single injection, there will be some pain. We will give you an information sheet about the bock, with tips on how best to care for the area of the operation while it is numb, and how to care for the pain when it wears off, as well as signs of unusual or concerning things. A member of our nursing staff will call you to check on your child and answer any questions you have. Any concerns about the block will be relayed to one of our of our regional anesthesia doctors, who will follow up with you if needed.
