Well, epidurals and spinals use "local" anesthetics to produce the block...and there is NO requirement for sedatives/anesthetics per se (if the block is good) so perhaps this is what they meant....
He could be entirely awake in there with an epidural or spinal block....just like me when I had my hernia repaired. You just have to be willing to lay there and be awake!
Also he has had many procedures over the years and is obviously used to being pulled about by the medical profession so I am sure he is approaching this one in a very positive action.
I am sure it helps with pre op mental attitude to know he has the love and support of his family in particular a wife whom it is obvious cares deeply for him as he does for her.
