There are three main types of local anaesthesia which are used for different purposes.
- Topical anaesthesia: a local anaesthetic is applied directly to your skin. It may be in the form of a gel or cream, or a spray.
- Subcutaneous anaesthesia (beneath the skin): this is an injection given just under your skin to target the nerves that create feelings of pain. Your skin and the area just below it feel numb.
- Regional anaesthesia: this is when a local anaesthetic drug is placed next to a nerve and numbs a large area or an area deep inside your body. The most common types of regional anaesthesia are spinal anaesthesia or epidural anaesthesia
You may have topical and/or subcutaneous local anaesthesia before:
- having blood taken
- a cannula (tube) is inserted in to a vein on the back of your hand before surgery or having epidural anaesthesia
- having a minor procedure; for example, you might have a spray to numb your throat if you’re having a gastroscopy (a procedure that involves putting a thin tube with a camera on the end down your throat to see inside your stomach)
You may have regional anaesthesia for procedures that affect the lower parts of your body such as a hip replacement, a caesarean or a bladder operation. Or you might have regional anaesthesia for a dental procedure or a wrist operation (radial nerve block). Regional anaesthesia might be used on its own, or with sedation or with general anaesthesia.
Sedation is when you are given anaesthetic medicine to help ease your anxiety and relax you before you’re having local or regional anaesthesia. You’re not unconscious and you can respond, but you feel as though you’re in a sleep-like state.
A sedative can be:
- inhaled as gas and air
- swallowed in tablet or liquid form
- injected using a fine plastic tube (cannula) into a vein on the back of your hand or in your arm
The type and dose of sedative will depend on your procedure and how anxious you are about it. You’ll be monitored from the moment you feel drowsy until the sedative wears off.
Topical local anaesthesia
Topical local anaesthesia is produced by rubbing or spraying a local anaesthetic on the skin. It is sometimes used to numb the surface area of your body before you have an injection or implant. This is so that you don’t feel pain from the needle.
Subcutaneous local anaesthesia
Subcutaneous local anaesthesia is produced by an injection under the skin and is a more effective method of numbing the area where you’re having treatment. It may be used before you have a minor surgical procedure.
A spinal anaesthetic is injected into the area that surrounds your spinal cord and will make you numb for about two hours. It’s designed to ensure that your lower limbs and the area below your tummy button are numbed.
An epidural anaesthetic is given through a small tube that is put into your back. Local anaesthetic medicine is given to you through this tube and topped up as you need it. Depending on how much medicine you have, the numbness might last for a few days. This method of regional anaesthesia can focus on a more specific area of your body; for example, it might be used for chest surgery.
A local nerve block is when a local anaesthetic is injected into the tissues that surround a nerve. This blocks the sensation to an area such as your hand or part of your jaw (this is used for dental procedures). It usually takes two to five minutes for a local nerve block to work. You may notice a warm tingling feeling as the anaesthetic starts to act. Your surgery or procedure will only go ahead once you’re completely numb. If you’re still feeling pain, your anaesthetist will give you some more anaesthetic.
You may also be offered a local anaesthetic to relieve pain after surgery, so you don’t need to take so many painkillers.
After local anaesthesia, you may be able to go home on the same day. If you have a sedative, you’ll need to be monitored for a while afterwards but will still usually be able to go home the same day. The length of time the anaesthetic takes to wear off depends on which type of anaesthesia you have.
If you have regional anaesthesia, it will take some hours before you get your feeling back. It’s important to protect yourself from injury while you’re still feeling numb.
As your feeling returns, you may notice a tingling sensation in the affected part of your body. Your doctor may recommend that you take painkillers once the anaesthetic wears off completely. Ask your anaesthetist about when you’ll be able to eat and drink afterwards, as this will depend on which surgery or procedure you’ve had.
There are some side-effects and complications that can happen after local or regional anaesthesia. Here, we’ve highlighted some of the main things to be aware of. Talk to your doctor or anaesthetist for more detail so that you feel informed and comfortable about what your treatment involves.
You may get:
- pain when medicines are injected
- bruising around the skin where you’ve been given a local anaesthetic
And with some types of local anaesthetic you may also get:
- headache (if you have a headache, you may need further treatment to ease this)
- damage to nerves
Anaphylaxis is a severe allergic reaction, which needs urgent treatment. It can happen with all types of anaesthetic.
- Royal College of Anaesthetists
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- Practical procedures. Oxford handbook of clinical surgery (online). Oxford Medicine Online. www.oxfordmedicine.com, published March 2013
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- Practical procedures. Oxford handbook of clinical medicine (online). Oxford Medicine Online. www.oxfordmedicine.com, published January 2014
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- Premedication. PatientPlus. www.patient.info/patientplus, reviewed 20 August 2014
- Sedative and analgesic peri-operative drugs. Joint Formulary Committee. British National Formulary (online). London: BMJ Group and Pharmaceutical Press. www.medicinescomplete.com, accessed 11 November 2015
- Local anesthesia and sedation. Medscape. www.emedicine.medscape.com, published 4 November 2015
- Wisdom Teeth Extraction: What to expect after the operation. Royal College of Surgeons. www.rcseng.ac.uk, accessed 11 November 2015
- Anaesthesia safety. RadiologyInfo.org. www.radiologyinfo.org, published 7 October 2014
- Radial nerve block. Medscape. www.emedicine.medscape.com, published 3 March 2014
- Sedation. Medscape. www.emedicine.medscape.com, published 13 August 2015
- Local anaesthesia for your eye. Royal College of Anaesthetists. www.rcoa.ac.uk, published 2014
- Oral nerve block. Medscape. www.emedicine.medscape.com, published 5 August 2015
- Important complications of anaesthesia. PatientPlus. www.patient.info/patientplus, reviewed 25 June 2014
- Royal College of Anaesthetists
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