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Local anaesthesia
Expert reviewers, Dr Ahmed Almaki, Consultant Anaesthetist and Melanie Hill, Bupa Clinics GP
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.
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Looking for prompt access to quality care?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.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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When would my dentist use a local anaesthetic? When would my dentist use a local anaesthetic?
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.
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Do local anaesthetics for eye surgery hurt? Do local anaesthetics for eye surgery hurt?
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.
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What can local anaesthetics treat? What can local anaesthetics treat?
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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Related information
General anaesthesia
General anaesthesia is when medicines are used to send you to sleep and stop you feeling pain and other sensations
Epidurals for surgery and pain relief
An epidural is an injection of a local anaesthetic and/or other pain-relieving medicine into a space that surrounds your spinal cord
Epidural injections for lower back and leg pain
Epidural injections into your spine can sometimes provide short-term relief from pain in your lower back and legs, which is known as radicular pain.
Over-the-counter painkillers
Over-the-counter painkillers are painkillers that you can buy from a pharmacy or shop, without needing a prescription from your GP.
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Other helpful websites Other helpful websites
- Royal College of Anaesthetists
www.rcoa.ac.uk
- Royal College of Anaesthetists
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Sources Sources
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- Emla cream 5%. emc. medicines.org.uk, last updated June 2019
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- Minor surgery. Oxford Handbook of General Practice. 5th ed. Oxford Medicine Online. oxfordmedicine.com, published online July 2020
- Wisdom teeth extraction. Royal College of Surgeons of England. www.rcseng.ac.uk, accessed January 2021
- Local anaesthesia with sedation. Medscape. emedicine.medscape.com, updated November 2017
- General anaesthesia. Patient. patient.info, last edited June 2015
- Miscellaneous conditions: Assessing fitness to drive. GOV.UK. gov.uk, last updated January 2018
- Patient FAQs. Royal College of Anaesthetists. www.rcoa.ac.uk, accessed January 2021
- Important complications of anaesthesia. Patient. patient.info, last edited June 2019
- Peri-operative analgesia. NICE British National Formulary. bnf.nice.org.uk, last updated December 2020
- Analgesia, anaesthesia, and sedation. Oxford Handbook of Clinical Dentistry. 7th ed. Oxford Medicine Online, oxfordmedicine.com, published online July 2020
- Ocular local anaesthetics. Patient. patient.info, last edited February 2017
- Sore throat (acute): antimicrobial prescribing. National Institute for Health and Care Excellence (NICE) Guideline NG84. National Institute for Health and Care Excellence. January 2018. nice.org.uk
- Lidocaine hydrochloride. NICE British National Formulary. bnf.nice.org.uk, last updated December 2020
- Oral ulceration and inflammation. NICE British National Formulary. bnf.nice.org.uk, last updated December 2020
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Author information Author information
Reviewed by Victoria Goldman, Freelance Health Editor and Natalie Heaton, Specialist Health Editor, Bupa Health Content Team, April 2021
Expert reviewers, Dr Ahmed Almaki, Consultant Anaesthetist and Melanie Hill, Bupa Clinics GP
Next review due April 2024
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