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Local anaesthesia
Expert reviewer, Dr Ahmed Almaki, Consultant Anaesthetist
Next review due October 2021
Local anaesthesia is when a part of your body is numbed with a medicine called a local anaesthetic. A local anaesthetic works by temporarily blocking the way your nerves carry pain signals to your brain. 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.
What is a local anaesthetic used for?
You may have a local anaesthetic to treat a painful condition or to relieve pain after an operation. You may also have a local anaesthetic before having:
- a needle put in your skin if you’re having an injection or a blood test, for example
- a tube (called a cannula) put into a vein on the back of your hand before surgery
- dental treatment
- a minor procedure – this could be anything from a gastroscopy to having a skin lesion removed
- a child – you might be given a local anaesthetic to relieve pain during childbirth (an epidural or spinal anaesthetic). For more information on this, see our section Types of local anaesthesia below.
- an operation where you need to block pain from an area of your body, such as your pelvis or legs – this is called a regional anaesthetic
Types of local anaesthesia
There are three main types of local anaesthesia, which are used for different purposes.
- Topical anaesthesia. This is when a local anaesthetic is applied to your skin. It may be in the form of a gel or cream, drops, an ointment or a spray.
- Subcutaneous anaesthesia. This is when a type of local anaesthetic is injected just under your skin to target the nerves that create feelings of pain. Your skin and the area just below it will feel numb afterwards.
- Regional anaesthesia. This is when a local anaesthetic is placed next to a nerve and numbs a large area or an area deep inside your body. Spinal and epidural anaesthetics are the most common types of regional anaesthesia but others include a nerve block. For more information on these, see our topics Epidurals for surgery and pain relief and Epidural injections for lower back and leg pain.
The different types of local anaesthetic medicine vary a lot in how long they take to start working, how long they work for and how much pain relief they give. Ask your doctor or anaesthetist about the medicine you’ll have.
Sometimes, you may have a combination of different types of anaesthesia. For example, you may have an operation under general anaesthesia, followed by a regional anaesthetic for pain relief.
How am I given a local anaesthetic?
Topical local anaesthesia
If you have topical local anaesthesia, your doctor or nurse will rub or spray a local anaesthetic on your skin. It’s sometimes used to numb the area before you have an injection or implant, for example, so you don’t feel pain from the needle.
Subcutaneous local anaesthesia
In subcutaneous local anaesthesia, your doctor or nurse will inject the local anaesthetic under your skin to numb an area where you’re having treatment. It may be used before you have a minor surgical procedure.
Regional anaesthesia
In regional anaesthesia, your doctor will inject the local anaesthetic near to the nerves that supply a larger or deeper area of your body to make it numb. Spinal and epidural anaesthetics are the most common types of regional anaesthesia.
A spinal anaesthetic is injected into the fluid that surrounds your spinal cord to make you numb in your lower limbs and the area below your tummy button. You might have it for some types of surgery such as surgery on your pelvis or legs, for example.
An epidural anaesthetic is given through a small tube that is put into your back. A local anaesthetic 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 surgery on your bladder. For more information, see our topics Epidurals for surgery and pain relief and Epidural injections for lower back and leg pain.
A local nerve block is another type of regional anaesthesia in which the local anaesthetic is injected into the tissues that surround a nerve. This blocks the sensation to an area, such as your hand, leg or head before you have a procedure.
How do 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. The length of time the anaesthetic takes to wear off depends on which type of medicine you have.
Whether or not you can drive after local anaesthesia depends on what type of procedure you had, and if this will affect your ability to drive. It will also depend on whether you were given a sedative as well as a local anaesthetic. If you were given a sedative, wait at least 24 hours before you get back behind the wheel. 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.
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 injure yourself. As your feeling returns, you may notice a tingling sensation.
Your doctor may recommend that you take painkillers before the local anaesthetic wears off completely.
Ask your anaesthetist or nurse about when you’ll be able to eat and drink afterwards. This will depend on whether or not you had general anaesthesia as well as local anaesthesia, and which surgery or procedure you had.
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Looking for prompt access to quality care?What are the side-effects of local anaesthesia?
There are some side-effects and complications that can happen after local anaesthesia. Here, we’ve highlighted some of the main things to be aware of.
You may get:
- some pain when the local anaesthetic medicine is injected
- some redness of your skin
- some bruising around the skin where you were given the local anaesthetic
- an infection
And 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) – usually this is only temporary
Although it happens very rarely, if the local anaesthetic gets into your circulation, you could experience a severe allergic reaction known as anaphylaxis. Or you could experience problems with your heart and nervous system. Ask your anaesthetist for more information.
What are the alternatives to local anaesthesia?
Alternatives to local anaesthesia include general anaesthesia, in which you're asleep during the operation. This isn’t as safe as local anaesthesia and takes longer to recover from. But you might prefer to be unconscious during your procedure. You can discuss your options with your anaesthetist or surgeon.
An alternative to having local anaesthesia after an operation is to have other painkilling medicine, such as morphine. You may have morphine given into a vein through an intravenous drip, which you can control. This is called patient-controlled analgesia (PCA).
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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
- Royal College of Anaesthetists
www.rcoa.ac.uk
- Royal College of Anaesthetists
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Author information
Reviewed by Rachael Mayfield-Blake, Freelance Health Editor, October 2018
Expert reviewer, Dr Ahmed Almaki, Consultant Anaesthetist
Next review due October 2021
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