When one discusses the experience of surgery under regional anesthesia or local anesthesia with IV sedation, an explanation of sedation is required. Patients are often very concerned about what they will feel or hear while receiving a regional anesthetic block or in the operating room during surgery.
At the MGH Orthopaedic Ambulatory Surgery Center, sedation plays a significant role in making your anesthetic and surgical experience more enjoyable. IV sedation will be used by the anesthesiologist either during the performance of a regional block or in the operating room during the surgical procedure.
When the anesthesiologist is performing a regional anesthetic block, he or she will administer IV medications that relieve anxiety and any minor discomfort before the performance of the block so that patients are usually unaware that they have experienced an anesthetic procedure. In other words, they don't even remember "the needle." Once patients understand that they won't feel discomfort during the placement of the regional anesthetic block, most of their anxiety is eliminated.
Once in the operating room and during the surgical procedure sedation also plays a major role. There is a broad spectrum of sedation you could receive in the operating room. This spectrum ranges from "light sedation' (aware of what's going but without anxiety) to "heavy sedation" (totally unaware-like sleeping at home). In addition, the level of sedation experienced varies from patient to patient. They may remember every detail of the surgery, or they may not remember anything until they wake up in the recovery room. There are many factors that determine how awake or asleep the patient is during the surgery, including the type of surgery, the patient's position, medical condition, and the comfort level of the surgeon and anesthesiologist. In the end, it is the joint decision between the patient, surgeon, and the attending anesthesiologist as to how to manage the patient's sedation and awareness during regional anesthesia in order to provide the safest, most enjoyable anesthetic and surgical experience possible.