Having a nerve block for shoulder surgery

What is a nerve block?

Pain messages are carried to the brain by nerves. A nerve block is the injection of a local anaesthetic numbing solution around a nerve to stop pain messages reaching the brain. This is generally done in the side of your neck or above your shoulder blade.

Why do I need a nerve block?

Shoulder surgery may cause considerable pain in the first 24 hours after the operation. One of the most effective methods of relieving this pain is to do a nerve block.

What are the benefits to me of having a nerve block?

Benefits of a nerve block may include a shorter recovery period and better pain relief.

You may not need as many strong pain relieving medicines like morphine. This will help reduce your risk of the side effects associated with these medicines such as

nausea (feeling sick) and drowsiness.

What does it involve?

Your anaesthetist will tell you what he/she is going to do. You may also choose to have a sedative to make you feel relaxed and sleepy while the block is done.

Are there any risks to me?

You should discuss these with your anaesthetist. Risks vary depending on the exact type of nerve block you have, but some of the risks with a nerve block are:

  • Nerve damage. This may be result in tingling, numbness or weakness. It is uncommon, but if it does occur, may last several weeks before getting better. Very occasionally it may be permanent.
  • Bruising or bleeding around the injection site (common)
  • A small lung puncture (uncommon)
  • The nerve block may not completely remove pain and you may still need some other pain killing drugs (common)
  • Local anaesthetic drugs can cause heart problems or loss of consciousness if accidentally injected into a blood vessel (uncommon)
  • Hoarse voice (common)
  • Shortness of breath (uncommon)
  • Droopy eyelid on the block side (common)

Source www.youranaesthetic.info

Are there any reasons I may not have a nerve block?

Yes, sometimes a nerve block may be dangerous or undesirable, and your anaesthetist will ask you about any medical conditions you may have.

How is the block done?

It is usually performed while you are awake although you may be given some ‘relaxing medication’ first. For shoulder surgery, this local anaesthetic nerve block is usually performed in the lower neck. The needle is positioned close to the nerve and local

anaesthetic solution is injected through it. This produces numbness and weakness in

the shoulder and arm. You will be unable to move your arm during this time – it will feel heavy and tingly,

When do I go to sleep? Can I have awake surgery?

Usually the anaesthetist will put you to sleep (a general anaesthetic) after the nerve block has been done.

Shoulder surgery can be done awake. The anaesthetist on-the-day may talk to you about this. There are some possible benefits of staying awake: you will avoid the risks and potential complications or side effects of a general anaesthetic; if you have a heart or lung condition, it may be safer; if you have diabetes, you can get

your diabetic control back to normal quicker; or patients may prefer it.

What will happen after my operation?

After your operation the nerve block will continue to make your arm/hand numb for a certain amount of time. During this time you should be aware that you could damage your arm/hand without being aware of the damage because it is numb, for example, you may not feel a hot coffee cup burning your hand. You should keep your arm in the sling provided until the feeling returns to normal. This is usually between 6 and 24 hours. If your block lasts longer than 48 hours you should contact the hospital for advice.

How can I get more information?

Your anaesthetist will be able to answer any questions you have. You should have been given a copy of our general leaflet ‘Information About Your Anaesthetic’.  Other information can be accessed via the Internet at www.youranaesthetic.info or www.portsmouthanaesthesia.com

Consent- What does this mean?

It is important before giving permission that you understand what you are agreeing to. If you do not understand – ask. More detailed information is available on request.

Information about you- The Data Protection Act 1998

Confidential records are kept about your health and the care you receive. These records are important; helping to make sure you receive the best possible care from us. The information may also be used to plan services and assist in the teaching and training of health professionals.

How to comment on your treatment

We aim to provide the best possible service and staff will be happy to answer any questions that you have.  However, if you have any concerns you can also contact pagwork@msn.com who will be happy to assist.

Author: Drs Marsh, Stedman, Taylor Anaesthetic Dept:  Produced Jan 2010:  Review: Jan 2012:  Ref: Ana/07

Updated: May 2013 – Taylor/Singh.

Used with permission.

© Portsmouth Hospitals NHS Trust

If you have any questions or concerns please contact us.