Anesthesia, Local Health Article

Risks

Side effects of regional or local anesthetics vary depending on the type of anesthetic used and the way it is administered. Any unusual symptoms following the use of an anesthetic requires the immediate attention of a doctor.

Paralysis after a regional anesthetic such as an epidural, spinal, or ganglionic blockade is extremely rare, but can occur. Paralysis reportedly occurs even less frequently than deaths due to general anesthesia.

There is also a small risk of developing a severe headache called a spinal headache following a spinal or epidural block. This headache is severe when the patient is upright, even when only elevated 30°, and is hardly felt when the patient lies down. It is treated by increasing fluids to help clear the anesthetic and enhance the flow of spinal fluid.

Finally, blood clots or abscess can form at the site where an anesthetic is injected. Although they can usually be treated, antibiotic resistance is becoming increasingly common. Such infections must be regarded as potentially dangerous, particularly if they develop at the site of a spinal injection.

A physician should be notified immediately if any of the following occur:

• symptoms of an allergic reaction such as hives (urticaria), which are itchy swellings on the skin, or swelling in the mouth or throat
• severe headache
• blurred or double vision or photophobia (sensitivity to light)
• dizziness or lightheadedness
• drowsiness
• confusion
• an irregular, too slow, or rapid heartbeat
• anxiety, excitement, nervousness, or restlessness
• convulsions (seizures)
• feeling hot, cold, or numb anywhere other than the anesthetized area
• ringing or buzzing in the ears
• shivering or trembling
• sweating
• pale skin
• breathing problems
• unusual weakness or tiredness

Normal results

Local and regional anesthetics help to make many conditions and procedures more comfortable and tolerable for patients.

BOOKS

Nettina, Sandra. Lippincott Manual of Nursing Practice, 7th edition. Philadelphia: Lippincott, 2001, pp. 115-117.

ORGANIZATIONS

American Academy of Anesthesiologist Assistants. PO Box 81362, Wellesley, MA 02481-0004. (800) 757-5858. <http://www.anesthetist.org>.

American Society of Anesthesiologists. 520 N. Northwest Highway, Park Ridge, IL 60068-2573. (847) 825-5586. <http://www.asahq.org>.

OTHER

Interview with Harvey Plosker, MD. The Pain Center. 501 Glades Road, Boca Raton, FL 33431.

Lisette Hilton Sam Uretsky, PharmD