Regional Anaesthesia (nerve blocks, spinal, epidural) – more information

It may be carried out as the sole anaesthetic or in combination with a general anaesthesia. It is usually carried out before the operation, but is also possible under general anaesthesia or at the end of the operation for post-operative pain relief

• Application of monitoring and siting of an intravenous cannula
• You will be positioned for the injection (e.g. sitting, on your side, on your back, an arm or leg bend)
• The skin will be cleaned with an antiseptic and aseptic precautions taken
• It may be carried out with or without the use of ultrasound as required
• Local anaesthetic is usually injected before the nerve block to numb the skin, this may sting or burn a bit.
• Discomfort and pressure are normal during the needle placement and injection. If you feel pain let your anaesthetist know so that he/she can change the needle position or give a pain killer
• When the needle is in the correct place local anaesthetic is injected around a nerve or a bunch of nerves
• You may get a warm, tingling and numb feeling as the local anaesthetic begins to take effect
• The anaesthetist will test the effectiveness of the nerve block and the operation will only go ahead when the required area is numb
• You may be conscious throughout the operation or receive some sedation to make you sleepy. You may also be given oxygen via a face mask.
• The anaesthetist will be near you and monitor you throughout the operation.

Spinal and Epidural Anaesthesia

Spinal and Epidural anaesthesias are the injection of local anaesthetic around the spinal cord and the spinal nerves to numb the nerves which are going to your legs and tummy. Spinal and epidural blocks are routinely used for Caesarean sections or pain relief in labour. However, they can also be used for large operations, such as laparotomies, bowel resections, kidney removals, amputations or hip / knee joint revisions. The choice of an anaesthetic or pain relief method also depends on the skills, experience and preference of your anaesthetist, and the method needs to be agreed in the consenting process before the operation.

Possible complications / risks with regional anaesthesia

 (sorted by probability of occurence)

1:10 to 1:100 (very common & common)

• Sickness and vomiting after surgery, dizziness
• Itching, shivering
• Aches, pains, backache
• Pain during injection of the local anaesthetic, bruising
• Difficulty emptying your bladder
• Headache (Epidural 1:100, Spinal 1:500)

1:1,000 (uncommon)

• Breathing problems
• Worsening medical condition

1:10,000 to 1:100,000 (rare & very rare)

• Heart attack, stroke
• Severe allergic reaction to drugs
• Nerve damage (temporary 1:2,000, permanent less than 1:10,000)
• Equipment failure
• Death (1:200,000)