PATIENT INFORMATION
Peripheral Nerve Blocks
Targeted pain relief for surgery involving the shoulder, arm, hand, hip, leg or foot.
A peripheral nerve block uses local anaesthetic medication to temporarily numb the nerves supplying the area where surgery is being performed. It may be used on its own, with sedation, or together with general anaesthesia.
Targeted pain relief
Blocks pain signals from a specific area of the body.
May reduce stronger pain medication
Can reduce the need for morphine-like medication after surgery.
Often used with other anaesthetics
May be combined with sedation or general anaesthesia.
What does it do?
It temporarily numbs a specific area by placing local anaesthetic around the nerves.
Will I be awake?
The block may be performed while you are awake, sedated or under anaesthesia.
How long does it last?
A single block commonly lasts several hours and may sometimes last up to 24 hours.
Why is it used?
It can improve pain relief after surgery and make recovery more comfortable.
WATCH
Peripheral nerve blocks explained
This short video explains how nerve blocks work and why they may be used as part of your anaesthetic care.
Your anaesthesiologist will discuss whether a nerve block is suitable for your procedure and answer any questions before your anaesthetic.
OVERVIEW
What is a peripheral nerve block?
Nerves carry sensation from different parts of the body to the brain. A peripheral nerve block involves injecting local anaesthetic around specific nerves to temporarily block pain signals from the area of surgery.
Depending on the operation, a block may be used for surgery involving the shoulder, arm, hand, hip, leg, ankle or foot. Your anaesthesiologist will explain which area of the body is expected to feel numb.
How the block may be performed
- Local anaesthetic is injected near the nerves supplying the surgical area.
- Ultrasound, a nerve stimulator or both may be used to guide the injection.
- If you are awake, you may feel pressure or brief discomfort.
- Tell your anaesthesiologist immediately if you feel excessive pain, tingling or electric-shock sensations.
BENEFITS
Why might a nerve block be recommended?
Better pain relief
A nerve block can provide very effective pain relief after surgery, especially in the first hours after your procedure.
Less need for strong medication
It may reduce the need for opioid or morphine-like medication, which can help reduce side effects such as nausea, drowsiness and constipation.
More comfortable recovery
Good pain control can make the early recovery period more comfortable and may support easier mobilisation, depending on the procedure.
TYPES OF BLOCK
Upper-limb and lower-limb nerve blocks
Upper-limb nerve blocks
An upper-limb block may be used for surgery or pain relief involving the shoulder, upper arm, elbow, forearm, wrist or hand.
The injection may be placed near the side of the neck, above or below the collarbone, or lower down the arm, depending on the operation and the nerves that need to be blocked.
Lower-limb nerve blocks
A lower-limb block may be used for surgery or pain relief involving the hip, thigh, knee, lower leg, ankle or foot.
The injection may be placed in the groin, buttock area, behind the knee or around the ankle, depending on the operation and the nerves being blocked.
Protecting a numb arm or leg
While a limb is numb, it is easier to injure it without realising. Until normal sensation and strength return, protect the affected area from heat, cold, pressure, awkward positions, accidental knocks or falls.
As the block wears off, you may feel pins and needles or tingling. Take the pain medication recommended by your doctor before the block wears off completely, as pain can return suddenly once sensation comes back.
MORE DETAIL
Common questions and important information
What if the block does not work fully?
Occasionally, a nerve block may not take away all the pain or may not work as expected. This can happen for technical reasons, anatomical differences, previous surgery, local tissue factors or other patient-specific reasons.
If the block does not provide enough pain relief, alternative pain medication or another pain-relief plan will be provided.
What is a nerve block catheter?
Sometimes, a very narrow plastic tube called a catheter may be left near the nerve so that local anaesthetic can be given continuously for a few days after surgery.
If you have a catheter, your anaesthesiologist or ward team will explain how it works and what to expect. Tell the ward staff or anaesthesiologist if you notice redness, swelling, increasing pain or discharge at the catheter site.
Common temporary effects
- Numbness in the blocked area
- Heaviness or weakness of the arm or leg
- Pins and needles as the block wears off
- Bruising or tenderness at the injection site
- Incomplete or failed block
Less common risks
- Bleeding or bruising around the injection site
- Infection
- Prolonged numbness or weakness
- Damage to nearby structures such as blood vessels, nerves or muscles
- Shortness of breath, hoarseness, facial numbness or visual disturbance with certain blocks
The risk of bruising or bleeding may be higher if you take blood-thinning medication. Please tell your anaesthesiologist about all medication you take, including prescribed, over-the-counter and herbal medication.
Rare but serious complications
- Permanent nerve damage
- Injection of local anaesthetic into the bloodstream
- Seizures or heart rhythm problems related to local anaesthetic toxicity
- Lung collapse with certain upper-limb blocks
- Significant bleeding or infection
Your anaesthesiologist is trained to reduce these risks, recognise complications early and treat them if they occur.
What if I do not want a nerve block?
A nerve block is usually recommended because your anaesthesiologist believes it may improve your comfort and recovery. However, you should feel free to ask questions and discuss alternatives.
If you do not want a nerve block, your anaesthesiologist will discuss other options for anaesthesia and pain relief, including their benefits and possible side effects.
When should I contact the hospital or anaesthesiology practice?
Contact the hospital, surgeon or anaesthesiology practice if you experience any of the following:
- Your limb remains numb for longer than expected
- Numbness or weakness persists beyond 72 hours
- Pain is not controlled by the prescribed medication
- You develop increasing redness, swelling or pain at the injection or catheter site
- You develop fever or chills
- You experience shortness of breath or chest pain
- You are worried about any symptom after your procedure
In an emergency, seek urgent medical care.
NEED HELP?
Still have questions?
Your anaesthesiologist will discuss the most appropriate anaesthetic and pain-relief options for your procedure.
