Skip Ribbon Commands
Skip to main content
menu iconMenu
search iconSearch

Surgery without “Going Under”


August 10, 2009  |  

Targeted Pain Relief Avoids Side Affects of General Anesthesia, Improves Recovery

Every year, 20 million patients in the United States undergo surgery requiring the use of general anesthesia. For some patients, the side effects of “going under” are more uncomfortable than the procedure itself. Common complaints include nausea, vomiting, mental confusion, sore throat, constipation and itching. For patients seeking a targeted approach to pain relief that speeds recovery, regional anesthesia may be the answer.

“Regional anesthesia offers patients a powerful form of customized pain relief that may be taken home if needed,” said Edward Mariano, MD, Chief of the Division of Regional Anesthesia and Acute Pain Medicine at UC San Diego Medical Center. “Post operatively, patients reduce or avoid the use of narcotics such as Vicodin and Percocet and return home sooner due to reliable and specific pain relief.”


Mariano said that regional anesthesia offers a powerful form of customized pain relief.

Rather than putting the whole body to sleep, regional anesthesia focuses on the part of the body that needs repair. Before surgery, an anesthesiologist uses ultrasound guidance to inject numbing medication around specific nerves, numbness which lasts from two hours to several days. For outpatient procedures, patients do not require intubation and can breathe without assistance. After surgery, the anesthetic may continue to be delivered by a small portable infusion pump in the hospital or at home.

“Without loss of consciousness, patients who have a nerve block may have a range of procedures such as facial, hand, breast, foot and ankle surgery, even hernia repair,” said Mariano. “Patients may choose to remain awake or be sedated for the surgery. Either way, patients are more alert and active immediately following their procedure if regional anesthesia is used.”

Most patients who undergo a combination of regional anesthesia and outpatient orthopaedic surgery at UCSD Medical Center go home within an hour after their procedure.  In a UCSD study of shoulder patients, those who received a continuous nerve block for two days required no additional oral pain medication. Other studies showed that patients with continuous nerve block infusions at home suffer fewer sleep disturbances and enjoy an overall better quality of recovery compared to patients who take narcotics alone. Overall, the studies show that sustained pain relief following surgery improves recovery by decreasing pain-related functional impairment and disability caused by narcotics.

Regional Anesthesia

The regional anesthesia team at UC San Diego Medical Center uses ultrasound guidance to pinpoint the nerve that requires numbing.

“Unlike the traditional intravenous administration of narcotics or epidural infusion, we found that a continuous nerve block following total knee replacement provided extended relief without prolonged hospitalization, suggesting a long-term benefit for a short-term intervention,” said Mariano.

Mariano further explained that patients with pre-existing cardiovascular or pulmonary conditions, and pregnant women and children in particular, benefit from an approach that does not impact the brain or other vital organs.

In the case of major surgery such as total hip or shoulder replacement, a combination of general anesthesia and regional anesthesia may be ideal. San Diego resident Gregory Stress, 59, found that with a dual approach he had better pain relief and a more rapid recovery compared to previous spine surgeries.

“The pain relief following my hip replacement surgery was tremendous,” said Stress. “I only took pain medication for the first 24 hours. I went home two days after surgery and never needed to fill the prescription for Oxycontin. Right away, I could shower, shave, cook and even walk stairs.”

Mariano founded the UC San Diego Regional Anesthesia Fellowship, California’s first advanced training program in regional anesthesia to be recognized by the American Society of Regional Anesthesia.  Mariano travels abroad twice per year to the Philippines and Ecuador as a volunteer anesthesiologist using regional anesthesia for orthopaedic surgery and pediatric facial plastic surgery.

Patients who would like to learn more about anesthesia options at UC San Diego Medical Center may call 800-926-UCSD.

# # #

Media Contact: Jackie Carr, 619-543-6163,

Media Contact

Related News

Using human embryonic stem cells, researchers at University of California, San Diego School of Medicine and Moores Cancer Center and Sanford-Burnham Medical Research Institute created a model that all ...
A binational team from the University of California, San Diego School of Medicine and the U.S.-Mexico Border Health Commission, Mexico Section has launched a new research project aimed at promoting pr ...
For parents who send their kids to dance classes to get some exercise, a new study from researchers at University of California, San Diego School of Medicine suggests most youth dance classes provide ...
Therapies that specifically target mutations in a person’s cancer have been much-heralded in recent years, yet cancer cells often find a way around them. To address this, researchers at University of ...
Researchers at University of California, San Diego School of Medicine and Shiley Eye Institute have identified the molecular “glue” that builds the brain connections that keep visual images clear and ...
Writing in the May 7 online issue of American Journal of Geriatric Psychiatry, researchers at University of California, San Diego School of Medicine and Veterans Affairs San Diego Healthcare System su ...
Each year, more than 10 million Americans seek medical attention, often in emergency situations, for symptoms of intestinal blockages. Researchers at the University California, San Diego School of Med ...
With the threat of multidrug-resistant bacterial pathogens growing, new ideas to treat infections are sorely needed. Researchers at University of California, San Diego School of Medicine and Skaggs Sc ...

Share This Article

Follow Us