General anesthesia, or being put to sleep, involves the administration of medications (usually by an intravenous route) that cause the patient to lose consciousness and become unable to feel pain. This state is maintained by the continual administration of medications, often including anesthetic gases, throughout the surgical procedure.

Regional anesthesia involves using local anesthetics to block the nerves supplying a particular area of the body. It is referred to this way because a ‘region’ of the body is anesthetized, in contrast to general anesthesia in which the entire body is anesthetized. Regional techniques include spinal and epidural anesthetics, which anesthetize the lower part of the body by injecting medications near or around the spinal column. Axillary, interscalene, and Bier blocks are techniques to anesthetize the shoulder or upper extremity and are very useful in surgery of the shoulder, arm or hand. There are many other less-often used nerve blocks which may be employed. Patients receiving a regional anesthetic generally receive intravenous sedation during the surgical procedure, which allows surgery to be performed with less anxiety and awareness on the patient’s part. Monitored Anesthesia Care involves the use of intravenous sedation along with careful observation and monitoring of the patient while surgery is performed under local anesthesia. The patient can be sedated as heavily as he or she wishes during surgery.

This technique allows the surgeon to concentrate on the operation while members of the anesthesia care team concentrate on the patient’s comfort and safety.