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Regional analgesia refers to the temporary blockage of pain in a localized area of the body by injecting an analgesic drug into the site. This is typically accomplished by nerve block or field block. Injecting an analgesic drug into the area close to the appropriate nerve is one way to create regional analgesia. Field blocking involves injecting around a surgical site multiple times to block pain response. Regional analgesia is also employed for pain management in critically ill patients.
When reducing pain in patients that are bed-ridden or suffering from opioid withdrawal, regional analgesia can play a valuable part. By reducing the need for high doses of opioids to manage pain, pain medication delivered via injections and peripheral catheters can reduce side effects such as gastrointestinal disorders and withdrawal syndrome. There are many areas that regional analgesia can be of help with, both on and within the body. Infiltration analgesia is a procedure whereby the nerve endings are anesthetized by injecting analgesia into the site subcutaneously, or beneath the skin.
An ankle block refers to regional analgesia on the foot by injecting around the tibial nerves near the ankle. Pain management of the arm, shoulder and hand is called brachial plexus block. An epidural block involves injecting analgesia into the epidural area. A lumbar plexus block refers to regional analgesia injected into the lumbar plexus. The lumber region encompasses the lower spine.
Analgesic drugs can be either non-narcotic or narcotic. Non-narcotic drugs can include acetaminophen and aspirin. Narcotics are drugs such as codeine and morphine. Combinations of drugs are also sometimes used to treat localized pain. For example, hydrocodone and ibuprofen or aspirin and codeine may be used in conjunction.
Some other methods of controlling pain in this localized manner include perineural, which is an injection given near the site of a nerve, and intraneural, which is when the injection is given within the nerve. The paraneural method injects the analgesic near the nerve trunk. The nerve trunk consists of bundles of nerves and is the main stem of the nerve. The analgesic then slowly seeps into the nerve tissue. The intraneural injection is given into the nerve itself and allows the medication to deaden the entire nerve.
Regional analgesia is a vital part of controlling pain during both surgical and dental procedures. It also allows the patient to recover quicker than they would if given a more general anesthetic.
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