Patient information

Your care pathway | Anaesthesia and you | Postoperative physiotherapy and you | Living with a sling or a splint | Injections and you

Anaesthesia and you

The aim of anaesthesia is to provide pain relief both during and after your operation. There are different types of anaesthesia that can be administered.

  • Local anaesthesia: A significant proportion of hand surgery can be carried out under local anaesthesia. An injection of local anaesthetic (Chirocaine, Marcaine) is given to the part of the limb that is going to be operated on. This will numb the entire area. During the operation you will be conscious and feel some sensation, but you will be free from pain.
  • Regional anaesthesia: In this type of anaesthesia, a major nerve or a bundle of nerves is anaesthetised (Inter-scalene, brachial plexus or axillary nerve block). This anaesthesia numbs larger and deeper parts of the limb. During the operation you will be conscious and feel some sensation, but you will be free from pain.
  • General anaesthesia: When this type of anaesthesia is administered you become unconscious and feel nothing. Even if you have had a general anaesthetic it is possible to have the operation as a day case.

For most shoulder and elbow surgery a combination of general anaesthesia and regional anaesthesia is used. The regional anaesthesia provides good postoperative pain relief. The arm will stay numb up to 24 hours. You may need painkillers as the anaesthesia starts to wear off.

Most minor upper limb and hand surgery can be carried out under local anaesthesia or regional anaesthesia. At the time of surgery a tourniquet is applied in the arm or upper forearm to control bleeding and make it easier for the surgeon to operate. This tourniquet can become uncomfortable after 20-30 minutes when the operation is performed under local anaesthesia.

Operations that take longer will need a combination of general and local anaesthesia. The local anaesthesia is for pain relief that will last up to 4-6 hours. You may need painkillers as the local anaesthesia starts to wear off.

A Consultant Anaesthetist who specializes in regional anaesthesia, will provide general or regional anaesthesia for you. While the Anaesthetist will try as accurately as possible to locate the nerves to block, sometimes regional anaesthesia may not work. It may have to be supplemented by local anaesthesia or converted to a general anaesthetic.

Your Anaesthetist will already have liaised with the Preoperative Assessment Nurse with regards to your medical status and fitness for anaesthesia. Your Anaesthetist will see you the day before your operation and discuss the anaesthetic with you. If you would like to meet your Anaesthetist before this, please let us know.

If you require more information about having an anaesthetic before coming in for surgery, you can visit the website of the Royal College of Anaesthetists (www.rcoa.ac.uk).

If you would like further information or would like to speak to us regarding treatment, don't hesitate to contact us