Local anaesthesia

Your health experts: Dr Ahmed Almaki, Consultant Anaesthetist and Melanie Hill, Bupa Clinics GP
Content editor review by Victoria Goldman, April 2021
Next review due April 2024

Local anaesthesia is when a part of your body is numbed with a medicine called a local anaesthetic. You may have a local anaesthetic to stop pain during and after surgery. Or you may use a local anaesthetic to treat a painful condition such as a sore throat.

How does a local anaesthetic work?

A local anaesthetic works by blocking the way your nerves carry pain signals to your brain. This numbing effect lasts for a short while. You’re still awake and aware of what’s going on around you, but you can’t feel any pain, usually just some touch and pressure sensations instead.

When would I have a local anaesthetic?

You may have a local anaesthetic before you have:

  • a needle put in your skin if you’re having an injection or a blood test
  • a tube (called a cannula) put into a vein on the back of your hand before surgery
  • dental treatment, such as having a tooth taken out – see our FAQ: When would my dentist use a local anaesthetic?
  • a minor procedure – this could be anything from a gastroscopy to having a skin lesion removed

You may also use a local anaesthetic to treat a painful condition such as a sore throat or haemorrhoids (piles).

You may have regional anaesthesia to:

  • numb a specific part of your body such as your pelvis or legs before an operation
  • ease pain during labour and childbirth (an epidural or spinal anaesthetic)

Sometimes, you may have a combination of different types of anaesthesia. You may have an operation under general anaesthesia, then a local or regional anaesthetic, such as an epidural, to ease pain afterwards.

Types of local anaesthesia

There are three main types of local anaesthesia:

  • topical anaesthesia
  • local anaesthetic injections
  • regional anaesthesia

Topical anaesthesia

You have a local anaesthetic put on your skin. It may be in the form of a gel or cream, drops, an ointment or a spray. This may be used to numb the area before you have an injection or implant, so you don’t feel pain from the needle.

Local anaesthetic injections

You have a local anaesthetic injected just under your skin to target the nerves that make you feel pain. Your skin and the area just below it will feel numb afterwards. You may have this before a minor surgical procedure.

Regional anaesthesia

Your doctor or anaesthetist will inject a local anaesthetic near a nerve to numb a large area or an area deep inside your body. There are three types of regional anaesthesia.

Spinal anaesthetics

A spinal anaesthetic is injected into the fluid around your spinal cord to numb your legs and the area below your belly button. This may be before some types of surgery such as a hip replacement.

Epidural anaesthetics

You have an epidural anaesthetic through a small tube that’s put into your back. The anaesthetic can be topped up through the tube as you need it, to ease any pain. An epidural anaesthesia can focus on a specific part of your body such as your bladder or before a Caesarean section. It also be used for surgery and pain relief and lower back and leg pain.

Nerve block

If you have a nerve block, the local anaesthetic is injected into the tissues around a particular nerve. This blocks the sensation to an area such as your hand, leg or head before you have a surgical procedure.

Having a local anaesthetic

If you’re having a topical anaesthetic cream before surgery, it’s usually put on your skin in a thick layer. It’s then covered with a dressing, which is taken off just before the procedure (for example, putting a needle in). The cream will usually be put on your skin at least an hour before your surgery, but no more than five hours before.

When you have a local anaesthetic injection, you’ll be asked to remain very still. You may notice a warm, tingly sensation as the local anaesthetic starts working.

If you’re having a nerve block, the anaesthetist will use an ultrasound scan or nerve stimulator to make sure the anaesthetic is going to the right nerve.

The health professional giving the local anaesthetic will only start the surgical procedure once they’re sure the anaesthetic is working and you don’t feel any pain. If you’re still feeling pain, it’s important to tell them because they will need to use more anaesthetic.

How long do local anaesthetics take to work?

  • Local anaesthetics vary in how quickly they work. Some local anaesthetic injections work after a few minutes. Others may take longer to work, up to around 30 minutes.
  • An anaesthetic eye spray can take just a few seconds to work.
  • A local anaesthetic cream can take up to 60 minutes to work.

How long do local anaesthetics last?

Some local anaesthetics last for longer than others. So, it’s important to discuss this with your anaesthetist or doctor.
  • Local anaesthetic creams may work for up to 90 minutes.
  • A local anaesthetic injection may last for up to three hours.
  • With an epidural, the numbness can last for a few hours or even a few days. This depends on how much medicine you’re given. You can also top up the anaesthetic so it lasts for longer, which is useful during labour.
  • A spinal anaesthetic can make you numb for around two hours.
  • If you have a nerve block, the area may stay numb for several hours.
  • How quickly will I recover from a local anaesthetic?

    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. How quickly you recover will depend on which type of anaesthetic you have.

    If you have regional anaesthesia, it will take some hours before you get your feeling back. It’s important to protect the area while you’re still feeling numb, so you don’t hurt yourself. As your feeling returns, you may notice a tingling sensation.

    Your doctor may recommend you take painkillers as the local anaesthetic wears off. Ask your anaesthetist or nurse about when you’ll be able to eat and drink afterwards. This will depend on which anaesthesia and which surgery or procedure you’ve had.

    Driving after local anaesthesia

    Whether or not you can drive after local anaesthesia depends on which type of procedure you’ve had. It will also depend on whether or not your anaesthetic will affect how well you can drive.

    If you were given a sedative as well as local anaesthetic, wait at least 24 hours before you drive. Ask your doctor for advice. Legally, it’s your responsibility to remain in control of a vehicle at all times. So, if your procedure or anaesthetic affects this in any way, it’s best to wait. You’ll also need to check your car insurance policy.

    What are the side-effects of local anaesthesia?

    Side-effects are unwanted but mostly temporary effects that you may have after local anaesthesia.

    You may notice a stinging sensation when the local anaesthetic medicine is injected into your skin. You may get a bit of pain when an epidural or spinal anaesthetic is injected.

    You may also get:

    • some redness of your skin – this may be caused by an allergy
    • some bruising around the skin where you were given the local anaesthetic
    • an infection
    • some bleeding at the injection site

    With some types of local anaesthetic, you may also get:

    • a headache (if you have spinal anaesthesia)
    • damage to nerves (if you have regional anaesthesia) – this doesn’t usually last for very long

    Most people don’t react badly to local anaesthetics. But you can get a very bad allergic reaction called anaphylaxis. Or you could have problems with your heart and nervous system. Ask your anaesthetist for more information.

    What are the alternatives to local anaesthesia?

    You may have general anaesthesia, which is when you're asleep during the operation. This isn’t as safe as local anaesthesia and you may take longer to recover afterwards. But you may prefer to be unconscious during your procedure. You can discuss your options with your anaesthetist or surgeon.

    If you don’t want to stay awake for a procedure but are having a local anaesthetic, you may be able to have a sedative. This means you’re in a sleep-like state but not unconscious.

    After surgery, you may be able to have other painkilling medicines, such as morphine. You may have morphine into a vein through an intravenous drip which you can control yourself. This is called patient-controlled analgesia (PCA).

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    You’ll usually have a local anaesthetic for most simple procedures on your teeth. This may be when you’re having a tooth removed or another dental procedure such as a filling. You’re more likely to have a general anaesthetic if you:

    • are very anxious
    • have an infection around the injection site
    • are prone to bleeding problems
    • are having major surgery

    You may be offered a sedative as well if you’re very anxious or if you’re having your wisdom teeth taken out.

    Local anaesthetic eye drops may sting at first, but shouldn’t cause any pain. They usually start working in less than a minute. Local anaesthetic injections for the eyes shouldn’t hurt at all.

    You may have a local anaesthetic if you’re having surgery near or on your eye – for example, having a cataract removed. Or you may have a local anaesthetic if you have something in your eye that is difficult to remove. A doctor or surgeon will decide which anaesthetic is the best one for you, depending on the procedure.

    You can buy some local anaesthetic products over the counter from pharmacies to treat some mild, common conditions.

    • Haemorrhoids (piles) – local anaesthetic creams may ease pain, burning and itching. But don’t use these for more than a few days or you could irritate your anus.
    • Sore throats – lozenges containing a local anaesthetic may help to ease pain. But research hasn’t found that local anaesthetic mouth sprays work very well on their own. Don’t use these products just before you eat, as you may choke on your food.
    • Mouth ulcers – you can buy local anaesthetic lozenges and sprays to ease mouth ulcer pain. But the numbing effect doesn’t last very long.
    • Sore nipples when you’re breastfeeding – you can use a local anaesthetic cream to ease the pain. But remember to wash it off before the next breastfeed.

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