Patient information Nerve Blocks Directorate of Anaesthesia PIF 1347 / V3
What is a Nerve Block? This is an injection of local anaesthetic near to the nerves that go to the area of your operation, making the area feel numb. The nerve block may be given on its own and you are kept awake throughout the operation or you may receive sedation or a general anaesthetic as well. What are the types of Nerve Block? There are many types of nerve blocks each aimed at a group of nerves that supply the surgery site. How long will the block last? This will depend on the site and the drug used. It can give pain relief for up to 18 hours after a single injection. Sometimes a catheter (a thin plastic tube) is left in place to allow an infusion of the local anaesthetic to run for a longer period (a few days). What are the benefits of a Nerve Block? Benefits of a nerve block may include a shorter recovery period and better pain relief after your operation. This allows you to be mobile more quickly after your operation. You may not need as many strong pain relieving medicines such as morphine. This will also help reduce the risk of the side effects associated with these medicines, which include nausea (feeling sick) and drowsiness. You may also be able to go home earlier. What are the risks of a Nerve Block? Although nerve blocks are generally safe to perform, there are risks associated which vary according to the site of the block, for example, nerve blocks done for shoulder surgery may commonly cause transient hoarse voice and a drooping eyelid. They can cause breathing difficulties that rarely require intervention.
The incidence of infection with all blocks is rare, although it is more likely if a catheter is left in place (incidence in medical studies ranges from 0-3 in a 100). Your anaesthetist will explain to you the risks associated with the type of injection you will receive. Some patients (between 1and 5 in a 100) have altered sensation in an area previously blocked by a local anaesthetic beyond the first 24 hours after their operation. This does not always relate to the block performed and can last for a few weeks and usually resolves completely. Permanent nerve damage is rare with an estimated incidence of between one in 5000 and one in 30000 nerve blocks. Are there any side effects from the local anaesthetic? These are rare. Your anaesthetist will make sure you are not allergic to any local anaesthetic drugs before giving you any. However, if you start feeling tingling and numbness in your mouth, ringing in your ears or muscle twitches you need to inform the nurse or doctor on the ward immediately. Will I be awake while the block is performed? If you are having your operation while you are awake, the block will be done with you awake. You will, however, be given medicine to make you more relaxed. You will feel a sharp scratch as a small needle is placed near the nerves to be blocked. Let your anaesthetist know if you feel excessive pain. If you are having your operation under a general anaesthetic, your anaesthetist will explain to you whether having the block awake or asleep is a better option.
Is there anything I have to do when I go back to the ward? You will have no feeling in the blocked part of your body. You may have pins and needles and sometimes a sense of heaviness. It is important to protect your limbs from excessive pressure and be aware of their position to avoid injury. What if I am still in pain? Your pain will be assessed regularly by the ward nurse and the acute pain nurse. If the pain relief is inadequate, you will be given other pain relief medication. The Acute Pain Team The Anaesthetist or Pain Nurse Specialist may visit you. This will give you further opportunity to ask any questions which may be worrying you and allow us to check that you are satisfied with the pain relief you are receiving. Further Information Do not hesitate to ask as we are only too happy to answer your questions. Your nurse will be able to contact us. Acute Pain Service Tel: 0151 706 3190 Author: Directorate of Anaesthesia Acute Pain Service Review date: March 2019
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