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Local anaesthetic

If you have a private operation planned, it may involve an anaesthetic procedure, in this instance a local anaesthetic. You may wish to know what this involves.
 
The information here is a guide to common medical practice. Each hospital and doctor will have slightly different ways of doing things, so you should follow their guidance where it is different from the information given here. Because all patients, conditions and treatments vary it cannot cover everything. Use this information when making your treatment choices with your doctors. You should mention any worries you have. Remember that you can ask for more information at any time.

 

 

What is the problem?

You need to have a small area of your body made numb for a surgical procedure. Local anaesthetic is often the most suitable way of keeping you safe and comfortable for a minor operation.   

 

What is a local anaesthetic?

A local anaesthetic is used for a small operation that normally involves the skin itself and the tissues just beneath the surface. It is used to numb (anaesthetise) a small area of skin. This is done by injections into the skin. These injections make the nerves in that area stop working for a short time. You therefore do not experience any pain.

 

As well as the injections into the skin, you may also be given medication into a drip. These drugs make you feel sleepy and relaxed and are called ‘sedation’.

 

The aims

The aim of the local anaesthetic injection is to numb the operation area, to allow you to have a pain free operation.

 

The benefits

A local anaesthetic injection is often the most suitable way of keeping you comfortable for an operation. A local anaesthetic is a good way of avoiding a general anaesthetic. As well as keeping you comfortable, the local anaesthetic helps the surgeon to do your operation with greater ease and safety.

 

Are there any alternatives?

There are many ways to prevent pain for an operation. These are all listed below. They all have more risks than a simple local anaesthetic injection. It may not be reasonable to expose you to these risks. For example, it is not reasonable to have a full general anaesthetic to remove a small skin tag. This is a tiny flap of skin less than a fingernail in size. This should be easy to do with local anaesthetic and maybe sedation.

 

General anaesthetic - You can have a general anaesthetic, where you are completely asleep throughout the operation. Other strong painkillers, such as morphine, can be given to keep you comfortable when you wake up.

 

There may be a medical reason why this is not suitable and this should be discussed with your anaesthetic doctor.

 

Epidural - It may be possible to perform an epidural where the lower part of the body goes numb and is pain free. This involves placing a plastic tube next to the nerves in the spine, so that drugs can be injected. This makes the nerves stop working temporarily so you feel no pain.

 

Spinal - Alternatively a single injection, like an epidural, but without putting the plastic tube in, can be used. This single injection is called a spinal. It does not last as long as an epidural.

 

Regional anaesthetic - Another method is to make individual nerves go numb temporarily. This could be your whole arm or leg. This makes a small region of the body numb, hence the name ‘regional anaesthetic’.

 

Hypnosis - More recently, some patients have used hypnosis to help them during an operation. Very few people can tolerate operations with hypnosis alone, but it may assist with the relief of anxiety, when used with other nerve blocking methods.

 

Whether any of these alternatives are suitable, depends on the part of the body to be operated on. The length of the procedure is also important. All of these injection methods can be used with sedation into a vein to help relieve anxiety.

 

If you are to have one of these procedures there is another information leaflet that will tell you more about it.

 

Who should have it done?

General reasons for having a local anaesthetic injection are listed below:

 

  • Where the operation is short and involves a small area of the body, like a finger.

  • Where the operation is not very painful.

  • When you are too unwell to take a general anaesthetic.

  • When you are too unwell for other anaesthetics, like an epidural.

Who should not have it done?

If you are unwilling to have a local anaesthetic then it may be possible to have a general anaesthetic, where you go to sleep for the surgery.

 

The only definite reason for not having a local anaesthetic is an allergy to the local anaesthetic drugs. In this case they cannot be used.

 

Author: Dr Sean White FRCA. Consultant in pain and anaesthesia

© Dumas Ltd 2006

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