Hand Block Surgery

The James Cook University Hospital has been piloting a new hand block service which uses local anaesthetic to numb the nerves so patients can stay awake to watch their operation and chat to their consultant throughout the procedure.

As patients do not have to be put to sleep there is less risk of nausea, vomiting and the complications associated with having a general anaesthetic. It also means patients can go home, and eat and drink, immediately afterwards.

Patients should have the full feeling back in their arm four to 24 hours later and are followed up with a phone call two days later.

Information about anaesthesia (block) for hand surgery

The group of nerves that control sensations in the shoulder, arm and hand is called the brachial plexus. These nerves can be temporarily numbed above the collarbone, below the collarbone or in the armpit depending on the operation required.

The process of temporarily numbing the nerves is called a block. The temporary numbness renders the arm pain free for the procedure and for several hours afterwards.

An ultrasound machine is used so the team can see precisely where the injection is going. Before your operation the anaesthetist will explain which block is most appropriate for you and will answer any questions you have.

Hand block procedure

  1. The skin overlying the area will be numbed.
  2. Local anaesthetic will be injected around the nerves. The arm goes numb in about 15 to 40 minutes.
  3. The blocks are tested for effectiveness by checking sensation with cold solution before and after the operation (the same nerves supply cold and sharp sensations). If the arm is not completely numb extra anaesthetic will be injected above/below the elbow.

Advantages of hand block surgery

  • You will be pain free for as long as the block lasts (usually 6 to 24 hours)
  • You will be able to eat and drink immediately after the operation
  • You will avoid the risks associated with having a general anaesthetic