I now need a doctor to testify that the norm is to give blocks before and after surgery, and that not using these blocks may have caused the RSD to spread. I am not aware of any studies that would back up this recommendation. I would have to do a current search in the literature to see if any hard data exists. There are other factors to consider in selecting regional over general anesthesia. There is a battle going on in Washington now because Medicare wants nurse anesthetists to give anesthesia without an MD anesthesiologist being present.
Anesthesiologists receive more training in regional anesthesia than nurse anesthetists.