The type of anaesthetic you have for your operation depends on several things including:
- How long or complex your operation is
- How fit you are and whether you have any medical problems
- Your choice
Most patients having a bigger operation will need a pre-assessment, or visit to our day surgery unit for a check up. Your anaesthetic options will be discussed with you.
Hand and wrist surgery is now often performed under regional anaesthesia. This means that only the part of your body that needs surgery will be numb. You might also get medicine to help you relax during the procedure.
What is a Nerve Block?
Nerve blocks are local anaesthetic injections around nerves to numb a part or region of the body like an arm, hand, leg or foot. Nerve blocks are also called regional anaesthesia.
The local anaesthetic blocks the nerves that carry pain and temperature signals from your body to the brain and some movement signals from the brain to your body for a period of time. This means that you will not be able to move the numbed part of your body part for a time after your nerve block. You may still feel touch and pressure even though your body part is numb, this is normal.
Nerve blocks will allow you to have an operation while you are awake. They avoid the risks of general anaesthetic, especially in people who have other medical conditions. You can compare the risks of regional and general anaesthesia are compared later in this information leaflet.
Nerve blocks can be used with medicine to help you relax or feel sleepy during an operation. Depending on how much is given, it might stop you from remembering much about the operation.
Nerve blocks can also be used as well as with a general anaesthetic to give pain relief for the operation. A nerve block can give pain relief for anywhere between 4 to 48 hours after an operation, depending on what is done.
Your anaesthetist will help form a plan with you of what would be best for you and for the operation you are having.
What are the benefits of a nerve block?
- Good pain relief after an operation
- Less strong morphine-like (opioid) pain relief medicines immediately after your operation. This pain relief can make people feel sick, constipated or confused.
- Being able to move about, eat, drink and go home sooner after an operation.
- Avoid general anaesthetic and the side effects and risks associated with this like sleepiness, sickness, or a sore throat.
How are nerve blocks carried out?
Nerve blocks are usually done in a room near the operating theatre. When you arrive to this room, a short plastic tube called a cannula will be put into a small vein in your hand or arm (not the hand or arm you are having the operation on) to allow medicines to be given to you during your operation. Monitoring will be connected to you to help keep you safe.
The anaesthetist will clean an area of your skin and a small amount of local anaesthetic will be injected into your skin to make it more comfortable when doing the nerve block.
A different needle is used to do the nerve block, and an ultrasound machine may be used to see the nerves and help make sure the local anaesthetic goes to the correct place. Most people find the nerve block to be no more sore than having the cannula put in.
After the nerve block, your arm will start to feel warm, tingly and numb. It may get heavy as well, and you may not be able to move it. The nerve block can take up to 40 minutes to work. The anaesthetist will usually check your sensation in the numbed arm to make sure that they are happy and the block working before going through to theatre.
If the block is not working fully when checked, you may be offered more local anaesthetic, different pain relief, or a general anaesthetic.
What happens during the operation?
A member of the anaesthetic team will be with you throughout your surgery. If you are not having a general anaesthetic, a screen will be positioned in the operating theatre so you cannot see the surgery. You will be able to listen to music through headphones to help you relax if you wish.
If you are having sedation with your nerve block, you will usually be relaxed and feel sleepy. You will be given oxygen to breathe through a small plastic facemask. You may have some memories of being in the operating theatre, although these may be hazy.
There are usually 8 or more people in an operating theatre, so do not be surprised if it is a busier place than expected. Every member has a role and will be helping to look after you.
What happens after the operation?
You will go from the operating theatre to an area near theatres called recovery. Here the team will make sure you are comfortable and safe to go back to the ward. You may be in recovery for a very short amount of time if you were awake or had light sedation, or longer if you have had a general anaesthetic.
Your body part that was nerve blocked will still be anaesthetised and feel heavy and numb. As the nerve block wears off, you will begin to feel pins and needles. This is normal.
When your nerve block is still working, you need to make sure you:
- Keep your numbed body part away from very hot or very cold things. You could easily hurt yourself without realising.
- Make sure you take pain relief medicines before the nerve block wears off, as instructed by the hospital team. Nerve blocks can wear off quickly.
- Support your numbed body part. It may be difficult to move your body part safely when it is numb. Keep it supported until the numbness wears off and you can move it normally.
- Avoid using machinery or domestic appliances like kettles, irons, ovens when numb.
- The body part that has had a nerve block may be weaker than expected to start with even when normal feeling comes back. Take care when standing or holding items.
Asking for help
You need to ask for emergency medical help if you:
- Find it unusually difficult to breathe
- You experience extreme pain that is not controlled by the pain killers recommended by the hospital team
If the nerve block has not worn off after two days, please contact the anaesthetic department via the telephone number on your discharge paperwork.
What are the risks of a nerve block?
Modern anaesthesia is very safe, but there are common side effects linked with both regional (nerve block) and general anaesthesia. Common side effects are usually not serious or long lasting. In very rare cases, nerve blocks can cause damage to nerves.
Very Common and Common (1 in 10 to 1 in 100) The equivalent of this happening to one person in your family to one person in a street
| Nerve Block | General Anaesthetic | |
| Feeling Sick | + | |
| Sore Throat | + | |
| Confusion | + | |
| Headache | + | |
| Itch | + | |
| General aches, pains or backache | + | + |
| Bruise or soreness from the injection | + | + |
| Dizziness or blurred vision | + | + |
| Conversion to General if block doesn’t work | + |
Uncommon (1 in 1000 people) The equivalent of this happening to 1 person in a village
| Nerve Block | General Anaesthetic | |
| Chest Infection | + | |
| Damage to teeth or lips | + | |
| Being unexpectedly aware during operation | + | |
| Breathing problems | + | + |
| Existing medical condition worsening | + | + |
Rare or Very Rare (1 in 10,000 to over 1 in 100,000) Equivalent to this happening to one person in a town or city
| Nerve Block | General Anaesthetic | |
| Sore eyes | + | |
| Serious allergy | + | + |
| Nerve injury | + | + |
| Death | + | + |
Your anaesthetist will discuss common risks with you, and support you to make a plan based on your goals, preferences, values and beliefs, and their experience, treatment options, current evidence and knowledge of risks and benefits.
What if I would prefer not to have a nerve block?
Despite our operating lists running as nerve block lists, if you still wish to have a general anaesthetic you can discuss this with your anaesthetic team on the day of your operation.
For more information:
Scan the QR code for a YouTube video with more information on Nerve Blocks
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