local anaesthesia sometimes refers to the administration of local anaesthetic drugs under the skin (or subcutaneously). In this technique, the local anaesthetic does not act on a specific nerve, but on a number of small nerves close to the area of skin or tissue where they provide sensation. When scheduled this way on the Operating Room schedule, this technique implies that the surgeon will give the drugs without any involvement of an anaesthetist.

Monitored (or anaesthetic) care

In many hospitals, anaesthetists provide care to patients having surgical procedures under local anaesthesia only, for example examination of the bladder (cystoscopy). The anaesthetist is available to monitor the patient and to provide intravenous or inhaled anaesthetic agents for additional sedation or pain relief. In the past, this type of care was often termed stand-by (because the anaesthetist was standing by, ready to intervene if necessary). This approach to patient care is now commonly referred to as ‘monitored anaesthetic (or anaesthesia) care’.

Because the anaesthetist is caring for the patient, the surgeon is able to focus on the operation, rather than having attention divided between the surgical field and the condition of the patient. For example, should a patient become distressed during the course of the operation, or suffer a complication from the procedure or the local anaesthetic, the anaesthetist provides necessary comfort or resuscitation and the surgeon can continue (if appropriate) with the procedure. One operation occasionally performed under 'local by surgeon' (or monitored anaesthetic care) is that of cataract extraction.