Regional anaesthesia: the gentler alternative to general anaesthesia
Regional anaesthesia, colloquially known as local anaesthesia, specifically numbs only the area of the body to be operated on and is regarded as a gentler alternative to general anaesthesia.
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Important note
This article is for information purposes only and is not a substitute for a medical diagnosis or advice. If you are unsure, or if you require a personalised treatment plan, it is essential that you consult a qualified specialist.
Alongside general anaesthesia, regional anaesthesia is a modern, safe and, for many procedures, gentler method of pain relief. It is often referred to in everyday language as „local anaesthesia“, as it specifically numbs only the part of the body that is to be operated on.
This article explains clearly and in detail what regional anaesthesia is, the different techniques available, and its advantages and disadvantages compared with general anaesthesia.
What is regional anaesthesia? A definition
What is regional anaesthesia? A definition
Regional anaesthesia is an umbrella term for various anaesthetic techniques in which a local anaesthetic is injected specifically near nerves in order to numb a larger area of the body (e.g. an entire leg, the lower body).
Unlike general anaesthesia, with regional anaesthesia alone the patient remains conscious, as the anaesthetic drugs act locally on the nerve pathways rather than in the brain.
The basic principle: targeted nerve block
The aim of any regional anaesthesia is to interrupt the transmission of pain from the surgical site to the brain. This is achieved by injecting a local anaesthetic, which temporarily blocks nerve conduction in that area. The procedures can be categorised according to the site of administration:
Procedures performed near the spinal cord
In this procedure, the anaesthetic is injected near the spinal cord in the lumbar region to numb the entire lower body. Ideal for operations on the legs, hips or in the lower abdomen.
- Spinal anaesthesia: The medicine is injected directly into the spinal canal, which is filled with cerebrospinal fluid. The effect sets in very quickly and is strong and reliable.
- Epidural anaesthesia (PDA): The medicine is injected into the epidural space (a space outside the dura mater). It takes longer to take effect. A thin catheter is often inserted, through which painkillers can be administered even after the operation.
Peripheral nerve blocks
In this procedure, individual nerves or entire nerve plexuses supplying a particular limb are specifically anaesthetised.
- Plexus block: Numb an entire nerve plexus, e.g. the brachial plexus, for operations on the entire arm or the shoulder.
- Single-nerve block: Numb only the area innervated by a single nerve, e.g. for an operation on the foot.
- Intravenous regional anaesthesia (IVRA, „Bier block“): The anaesthetic is injected into a vein in the arm or leg, from which blood has been drained (by tying off the limb) – suitable for short procedures on the extremities.
Combined with twilight sleep (analgosedation)
One of the most common concerns patients have is being conscious during the operation. For this reason, regional anaesthesia is very often combined with twilight sleep.
During the procedure, you will be given a sedative and a sleeping aid via an intravenous line, which will put you into a light, shallow sleep. You will breathe independently throughout, but will not be aware of the operation, either audibly or visually.
Regional anaesthesia versus general anaesthesia: a comparison
| Criterion | Regional anaesthesia | General anaesthesia |
|---|---|---|
| Awareness | The patient remains awake (often combined with twilight sleep). | The patient is in an induced coma. |
| Breathing | Spontaneous and independent. | On mechanical ventilation (usually via a tube). |
| Circulatory strain | A lower, often more stable circulation. | The more powerful it is, the more control it requires. |
| Post-operative nausea | Much less common. | More often. |
| Pain management after surgery | Very good, as the anaesthetic is still taking effect. | Requires immediate administration of painkillers. |
| Suitable for | Surgery on the limbs and lower body. | All surgical procedures, particularly lengthy operations on the head, chest and abdomen. |
Frequently Asked Questions about Regional Anaesthesia
For many patients, particularly older patients or those with certain pre-existing conditions, it is considered a gentler and lower-risk option, as it places less strain on the circulatory system and does not require ventilation. Both procedures are carried out to an extremely high standard of safety in Germany.
The skin at the injection site is first numbed with a local anaesthetic, so that you will usually only feel a sensation of pressure when the spinal or epidural needle is actually inserted.
The fear of becoming paraplegic is understandable, but the risk is negligible if the procedure is carried out correctly by an experienced anaesthetist. The injection is administered in the lumbar spine region, where the spinal cord is no longer present.
We would be happy to provide you with information about insurance cover for your operation and the associated financial consequences of any complications arising in connection with the insured procedure and the anaesthesia required for it.
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