Things that are not about sleep…
A quick version of describing what we do in anaesthesia is that we look after people being comfortable and safe while they have a procedure done. A lot of the time that involves a general anaesthetic.
We often talk about that general anaesthetic as if it is like being asleep. It turns out it’s not the same as standard old sleep. It is more like a controlled state of unconsciousness and the medicines we use make you unaware of anything happening.
The thing is, those medicines do not necessarily deal directly with the pain or discomfort that can happen with surgery. For that there are lots of different options. So we thought this might be a good chance for a quick discussion about regional anaesthesia.
Now when we say ‘regional anaesthesia’ we’re not talking about anaesthesia that is happening away from a big city centre. What we are talking about is … well, actually we have someone to help explain that.
This hugely expands the options available for helping keep patients comfortable. As mentioned in the video, local anaesthetic placed carefully near the nerve effectively blocks the pain signals returning from that spot.
The possibilities expand even more when you consider that you can choose different local anaesthetics to produce a different duration of effect. Additional medicines combined with the local anaesthetic can make the effect time even longer. Or you can place specialised equipment to keep delivering local anaesthetic over a number of days to keep that pain relief working.
And if you’ve read this far you may well have already thought ‘wait, aren’t there are nerves all over the body?’
There are, which means the range of possibilities becomes big in an entirely different way. The availability of ultrasound has made a huge difference to our ability to provide regional anaesthesia and created a huge surge in interest in these techniques.
Being able to see the nerve makes a huge difference, although it turns out that because the characteristics of nerves in different spots can be quite different, the appearance of a nerve is not the same in every place you look. There are nerves everywhere, although they do not all look the same under the glare of those clever sound waves.
The availability of ultrasound has also led to the development of an increased range of fascial plane blocks. This is where the local anaesthetic is applied not so much close to the nerve, but in a tissue plane through which the nerve has to pass. The nerve still ends up bathed in the medicine that will block those pain signals.
This whole area highlights just one of the amazing things about anaesthesia. It’s not only that it’s about a bit more than sleep. These advances in technology and the improvements in equipment available keep opening up new possibilities.
We can do more and more for our patients. And that’s what we’re here for.