What are they?
Nerve blocks are used to give pain relief to children when they have an operation.
They are usually given as a single injection when the child is asleep, under general anaesthetic, but they can be inserted as a catheter (tube) when the child is asleep under general anaesthesia and then run continuously over a period of time (an infusion).
How does it work?
Nerves send pain messages to the brain via the spinal cord. A medicine called a local anaesthetic is given around the nerves that travel from the part of the body that is having the operation. This medicine numbs the nerves and so reduces pain.
Why do we use nerve blocks?
Nerve blocks can significantly reduce the amount of pain after an operation. This can reduce the amount of other pain medicine that the child needs as well and so reduce unwanted effects of these other pain medications, such as sickness and drowsiness.
How long does it last?
A single injection nerve block can provide pain relief for 8 to 24 hours. If the medicine is given continuously through a very small tube (catheter) it can give pain relief for as long as the catheter is being used. This is usually 2 to 3 days.
What does it feel like?
Your child may feel numb around the operation area. If the operation is on an arm or leg, then the whole arm or leg may feel numb.
Sometimes the area may feel heavy, tingly or weak. This is normal. If there is weakness, this usually wears off first, followed by the heavy or tingly feeling.
Although muscle strength is not affected, the abnormal feeling can make the child wobbly when standing or walking.
Could there be any complications?
Complications are rare after a nerve block.
They can include:
- Less than perfect pain relief
- Infection – rare
- Long-lasting or permanent nerve damage – extremely rare
There may be complications to a specific nerve block, depending on the area that is to be numbed. The anaesthetist will discuss these with you before the operation.
Care after a nerve block
The area where the nerve block has been performed will be very numb and so needs to be protected from heat, sharp objects or similar hazards as the child will not feel an injury.
It is important to take the regular pain medicine prescribed to reduce any pain or discomfort as the numbness wears off.
What if the block lasts more than a day?
It is possible that some blocks may last longer than one day. However, if the child is not able to move the arm/leg or cannot feel any sensation (touch, warm, cold, pain) more than 24 hours after the nerve block was placed please contact the paediatric ward for advice.
Continuous nerve catheters
Sometimes a child may require the numbing medicine to be given for a longer period of time after more painful surgery. This can be done by insertion of a very small tube near the nerves that need to be numbed.
The medicine is given continuously using a pump to keep the area numb until it is no longer required. Afterwards the small tube is removed. This is not painful.
The anaesthetist will discuss the nerve block with you before the operation.
South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Department who will advise you on how best to do this.
This service is based at The James Cook University Hospital but also covers the Friarage Hospital in Northallerton, our community hospitals and community health services.