Information for parents, carers and patients about: Peripheral Nerve Blocks and Infusions

An anaesthetist will carry out the nerve block while your child is asleep under general anaesthetic.

It is usually done just before their operation. An ultrasound machine is used to guide the anaesthetist in finding the correct nerve and surrounding structures. The exact nerves blocked depends on the type of operation your child is having, and the anaesthetist will explain this to you before your child’s operation.

The nerve block usually lasts between 6 and 24 hours after the operation.

If your child’s operation is more complex, we may insert a nerve block catheter (a small plastic tube) during the operation.

We can use this catheter to give your child local anaesthetic, providing pain relief for several days after their operation.

Benefits:

• Provides pain relief both during and after the operation.
• Improved pain relief reduces the need for stronger pain medications. This can reduce the side effects from these medications, such as feeling sick and vomiting drowsiness, difficulty passing urine and itching.
• Faster recovery and ability to eat and drink sooner after the operation.

Risks:

Complications from nerve blocks are rare. Several large studies show they are generally very safe. Risks can include:

• Partial effect or no effect at all. Sometimes the nerve block may not work as expected. If this happens during the operation, the anaesthetist will use other methods to provide pain relief (please see the alternatives below).
• Bruising or bleeding at the site of injection
• Infection – this is rare.
• Nerve damage. Some children may notice a patch of numbness or tingling after a nerve block has worn off. This usually gets better in a few weeks but may last up to 1 year. A recent study looked at over 100,000 nerve blocks in children. It found temporary nerve damage happened in less than 3 children for every 10,000 treated. There is a small risk of permanent nerve damage, although this is rare.
• Local anaesthetic toxicity. This is very rare but can be serious. This is when local anaesthetic solution is accidentally injected into a blood vessel. We will closely monitor your child for any signs of this. We are trained to deal with local anaesthetic toxicity should it occur.

Please discuss alternative methods of pain relief with your anaesthetist. These may include using strong pain medications (given by mouth or into a vein), or local anaesthetic injected by the surgeon around the surgical site.

It may take up to 24 hours for the numb sensation from the block to fully resolve.

We may send your child home with the block still working. If the numb sensation lasts longer than 48 hours, and you are no longer in the hospital, please contact the anaesthetic department on: 0141 452 4342.

For advice outside of the hours of 9am–4pm, Monday to Friday, please call the hospital switchboard and ask to be connected to the paediatric anaesthetic registrar.

A member of the team will take your child’s details, and an anaesthetist will call you to discuss your concerns. They may give you advice over the telephone or ask you to return to the hospital for an anaesthetist to examine your child.

As the block begins to wear off your child may experience a tingling sensation or pins and needles. This is normal.

It is important that you give your child simple pain relief, like paracetamol and, or ibuprofen, while the nerve block is still working. This will help keep your child comfortable as the numbness fades.

Your child may need further pain relief as the block is wearing off. Your anaesthetist will discuss this with you before the operation and advise you on how best to manage this.

It is very important to protect the numb part of your child’s body while the nerve block is still working. This means avoiding sources of heat (such as hot water bottles, radiators or hot baths), as your child won’t be able to feel if something is too hot. This helps reduce the risk of burns. It is also important to avoid any trauma or injury to the numb part of your child’s body.

If the block is performed on a limb, it is important to remember that your child’s limb will not be as strong as normal.

If the block is performed on your child’s leg, they will need to be supervised when they are walking or crawling. This helps reduce the risk of falls.

If the block is performed on their arm, we will give them a sling to help protect it. They should not sleep on top of the affected arm if it is still numb.

Day Surgery: 0141 452 4337

Paediatric anaesthetic department: 0141 452 4342

Hospital switchboard: 0141 201 0000

Please get medical attention if you have any concerns about your child after their operation.