LOCAL ANAESTHETIC

  A Guide for Patients

Introduction

This booklet provides information for you and your family regarding local anaesthetic for your surgery. Your decision on treatment must be based upon weighing the benefits against any risks.

What is a local anaesthetic?

A local anaesthetic is a drug that is injected into the tissues to make them numb. Your anaesthetic will be given to you either by your surgeon or by your anaesthetist (doctor trained in anaesthesia).

A local anaesthetic may have been recommended for your operation. However, it is your decision to go ahead with a local anaesthetic or not. This document will give you enough information about the benefits and risks so you can make an informed decision.

If you have any questions that this document does not answer, you should ask your surgeon or anaesthetist, or any member of the healthcare team.

How does a local anaesthetic work?

Local anaesthetics temporarily stop nerves working so that you do not feel pain. The simplest form of local anaesthesia is to inject the drug just around the area where the operation is going to take place. This tends to sting or burn for a few seconds and then the area goes numb. The feeling of pain goes away much sooner than the feeling of touch, so do not be alarmed if you can still feel pressure or movement. It is also possible to numb all the nerves to an arm or a leg (called a regional block).

The procedure will not start until you and your surgeon are both satisfied that the area is numb to pain.  Although the ‘starting area’ is numb, the operation may reach areas that have not been numbed. If this happens, your surgeon will give you some more local anaesthetic until those areas are numb to pain.

Local anaesthetics generally work for a few hours, depending on the type of drug and dose used. After this time the area should go back to normal.

Are there any alternatives to a local anaesthetic?

If you are concerned about being awake during the operation, it may be possible for it to be performed under a general anaesthetic. However, there are complications associated with a general anaesthetic.

Other anaesthetic procedures may be possible such as an epidural or regional block, although these also use local anaesthetic drugs.

Sometimes it may be possible to use sedation as well as a local anaesthetic.

What complications can occur?

The healthcare team will try to make your anaesthesia as safe as possible. However, complications can occur. Some of these can be serious and very rarely even cause death. The possible complications of a local anaesthetic are listed below. Any numbers which relate to risk are from studies of patients having this anaesthetic. Your doctor may be able to tell you if a risk of a complication is higher or lower for you.

*   Not enough pain relief, which is usually corrected by giving more local anaesthetic. Occasionally other forms of drugs or anaesthetic have to be given as well. Let your surgeon know if you are in pain.

*   Allergy to local anaesthetics This is very rare. Many people have been told, or think, they are allergic to local anaesthetic given at the dentist. This is rarely the case, but you should let the person giving your local anaesthetic know about any problems including the drugs that you have had in the past.

*   Bleeding, if the needle used to inject the local anaesthetic strikes a blood vessel. This usually results in a small bruise that will not cause problems.

*   Permanent nerve damage. This is very rare. Occasionally the local anaesthetic has a longer effect than expected (up to 48 hours) but this usually settles down on its own.

*   Absorption into the bloodstream, if the local anaesthetic is accidentally injected into the bloodstream or if it is absorbed into the bloodstream more quickly than usual. This is very rare but can cause various problems temporarily affecting the heart and brain, which can be serious. The dose of local anaesthetic is always limited to reduce this risk.

You should discuss these possible complications with your surgeon or anaesthetist if there is anything you do not understand.

Summary

A local anaesthetic can be used for most people, giving a safe and effective form of pain relief both during and after your operation. However, complications can happen. You need to know about them to help you make an informed decision about your anaesthetic. Knowing about them will also help to detect and treat any problems early.

Partners in Care

We want you to be our partner in care. Please try to help by:

*  providing full information on your health history and related matters;

*  following the advice given to you;

*  accepting responsibility if you refuse treatment or medical advice;

*  taking reasonable care of your own property and respecting the property of other people in

   Hospital;

*  keeping appointments and giving adequate notice if unable to do so;

*  switching off your mobile phone when in hospital;

*  not smoking;

*  ensuring reasonable and responsible behaviour by yourself and your visitors;

*  return any equipment when you have finished with it.

If you have any questions, which are not answered by this booklet, then please don’t hesitate to ask your doctor or one of the nursing staff.