​Statement on Regional Anesthesia

Developed By: Committee on Anesthesia Care Team
Last Amended: October 26, 2022 (Original Approval: October 12, 1983)

While scope of practice is the purview of appropriate licensing and credentialing authorities, the American Society of Anesthesiologists, as an organization of physicians dedicated to enhancing the safety and quality of anesthesia care, believes it is appropriate to state its views concerning the provision of regional anesthesia. These views are founded on the premise that patient safety is the most important goal in the provision of anesthesia care. 

Anesthesiology, including regional anesthesia and acute pain medicine, is the practice of medicine. Regional anesthesia involves diagnostic assessment, consideration of indications and contraindications, prescription of drugs, and institution of corrective measures and treatment in response to complications. Therefore, the successful performance of regional anesthesia requires medical as well as technical expertise. 

The medical component generally comprises the elements of medical direction and includes: 

1. Preanesthetic evaluation of the patient and education regarding regional anesthetic techniques and multimodal analgesic options. 
2. Development and prescription of the anesthetic and analgesic plan.
3. Ensuring that the regional anesthetic is performed in an appropriate physical environment where necessary medications (including lipid emulsion), equipment, and personnel are immediately available. 
4. Personal participation in the technical aspects of the regional anesthetic when appropriate. 
5. Following the course of the anesthetic.
6. Remaining physically available for the immediate diagnosis and treatment of emergencies. 
7. Providing indicated postanesthesia care and follow-up after regional anesthetic and analgesic techniques. 

The technical requirements for regional anesthesia and analgesia will vary based on the procedure to be performed. 

Choosing the most appropriate anesthetic technique is a shared process that involves physician judgment, medical decision making, and patient and caregiver education and participation. Physician anesthesiologists with competence and skills in regional anesthesia are best suited to select and perform regional anesthetic and analgesic techniques. Patient outcomes may be improved when regional anesthetic techniques are made available and accessible to all patients equitably. Interrupting or aborting a technically difficult procedure, recognizing and managing complications, and conveying the risks and benefits of regional anesthesia to patients and other healthcare professionals are among the responsibilities of a physician.