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Local anaesthesia and sedationThis factsheet is for people who are considering having a local or regional anaesthesia and/or sedation. The word "anaesthesia" comes from a Greek word meaning absence or loss of sensation. Anaesthesia is one of the most significant developments of modern medicine because it allows once-unbearable medical procedures to be performed while the patient is relaxed and/or asleep.
What is local anaesthesia?Local anaesthesia stops you feeling pain without putting you to sleep. It blocks the way nerves carry pain signals to your brain. Local anaesthetic drugs are usually only used for short, simple operations such as stitching a wound or removing a mole. Depending on the drug used, the numbing effect can last from about two to eight hours. Preparing for a local anaestheticYou don't need to make any special preparations to have treatment under a local anaesthetic. You will usually be allowed to eat and drink as normal before you arrive but if you are unsure about this, please contact your doctor. How is it given?Local anaesthetic drugs can be:
The treated area will very quickly start to lose feeling. Your operation won't start until your doctor is absolutely sure that the area is numb. It is important to realise that local anaesthesia takes away feelings of pain, but you may still feel pressure and movement during your operation. After a local anaestheticYou will be able to go home shortly after the procedure. Take care not to injure the area which has been numbed, as you may not be able to feel the damage. What is sedation?Sedative drugs relieve anxiety and cause temporary relaxation without putting you to sleep. Sedatives are often used to help people relax during medical procedures. You will remember very little about the treatment done under sedation. Sedative drugs don't block the pain signals to the brain, so local or regional anaesthesia is often given as well. How is sedation given?Sedation can be:
The type and dose of sedative given depends on the procedure and how anxious you are about it. Sedation is commonly used during many procedures such as colonoscopy, gastroscopy and cataract operations. Preparing for sedationThe instructions will vary depending on the type of sedative you are given. Inhaled sedation doesn't usually require any specific preparation, but it can sometimes make you feel nauseous, so you may be asked to eat only light meals before your procedure. If sedatives are being injected or swallowed then you may be asked not to eat for six hours before your procedure. Ask your doctor for specific advice about sedation. During sedationSedatives can sometimes affect your breathing. While you are sedated, the amount of oxygen in your blood will be monitored constantly through a small clasp on your finger and you may be given extra oxygen through a mask or a plastic nasal tube. After your sedationYou will be allowed to go home after most of the effects of the sedation have worn off. The effects of any sedative may last longer than you expect. Do not drive, drink alcohol, operate machinery or sign legal documents until your doctor tells you that it's safe to do so. This will be at least 24 hours after the treatment. This means you will have to arrange for someone to drive you home. If you have children or other dependants, you may need to arrange for someone to care for them during this time. If you are in any doubt about driving, please contact your motor insurer so that you are aware of their recommendations, and always follow your doctor's advice. Other types of anaesthesiaThere are two other types of anaesthesia available.
Regional anaesthesiaRegional anaesthesia uses similar drugs to local anaesthesia. However, the drugs are injected around the main nerves that carry signals from the area of the body being treated. Regional anaesthesia can also block the nerves that control your muscles. So, as well as feeling numb, you may not be able to move the affected area until the effects wear off. Regional anaesthesia is also used for people for whom general anaesthesia is not suitable, and it can be used for major operations like hip replacements. Spinal anaesthesiaSpinal anaesthesia is one of the most common types of regional anaesthesia. It involves an injection of anaesthetic into the fluid that surrounds the nerves in the lower back, and is used for operations below the waist or in the pelvic region. The patient is completely numb from the waist down for a couple of hours or so. Epidural anaesthesiaAn epidural uses a similar technique to spinal anaesthesia, with a narrow plastic cannula left in position near to the nerves in the back. This means that the anaesthetist can give repeated doses of local anaesthetics (and painkillers) without further injections. This makes it useful for postoperative pain relief and for use during childbirth, because the cannula can be left in place for up to several days. Epidural anaesthesia is also commonly used during leg and pelvic operations. Preparing for regional anaesthesiaIf your operation is going to involve having regional anaesthesia you will be given specific advice well in advance, which may include instructions not to eat or drink for a few hours before your operation. After your regional anaesthesiaIt may take several hours for the effects of regional anaesthesia to wear off depending on the technique used. You should arrange for somebody to drive you home. Deciding to have local anaesthesia or sedationLocal anaesthesia, regional anaesthesia and sedation are commonly performed and generally safe procedures. In many cases there are clear advantages over general anaesthesia, such as speed of recovery and lower risk of complications. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications. Side-effects are the unwanted but mostly temporary effects of successful treatment. After a regional anaesthesia your blood pressure may temporarily drop. This may make you feel weak or cause you to faint. You may also have temporary loss of muscle control in the treated area. Sometimes the skin over the numb area turns very pale for a short while. If you have a spinal or epidural anaesthesia, you will need a temporary catheter. This is a thin tube passed into your bladder to help urine flow. If you have sedation, you may get a headache, feel nauseous or be sick, and have feelings similar to those of a hangover. Most people have some amnesia about the procedure and, rarely, unpleasant memories of the procedure. Complications are unexpected problems that can occur during or after the procedure. Most people are not affected. With any procedure involving anaesthesia there is a very small risk of an unexpected reaction to the anaesthetic. Regional anaesthesia, epidurals and other spinal techniques carry a very small risk of infection, damage to nerves and possible paralysis. Severe headaches can occur after epidurals and spinals, but these are rare. Ask your doctor to explain how these risks apply to you. The exact risks will differ for every person. This is one of the reasons why we have not included statistics here. Further information
Sources
Published by BUPA's health information team, healthinfo@bupa.com, December 2006.
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