Having an anaesthetic for your shoulder procedure?
All you need to know
You may be having a shoulder operation for a fracture, tendon or ligament injury/tear, replacement operation or any other elective procedure (keyhole or open technique). Having an operation can be a stressful experience. This is designed to give you some basic information and help you prepare for an anaesthetic for your surgery.
On the day of your operation
Nothing to eat or drink – fasting (‘Nil by mouth’) The hospital will provide you clear instructions about fasting. It is important to follow these.
- If you are a smoker—it is highly recommended that you quit smoking as smoking has been negatively linked to bone and tissue healing after surgery
- This will help avoid breathing problems during your anaesthetic.
- If you are taking medicines, you should continue to take them as usual, unless your nurse, anaesthetist or surgeon has asked you not to.
- If you feel unwell when you are due to come into hospital, please contact the hospital for advice.
Your Anaesthetic options
You may be aware of a number of different anaesthetic options that can be used for this type of surgery.
- A nerve block where you stay awake (with or without sedation).
- A nerve block with general anaesthetic.
- A general anaesthetic (being fully asleep)
The anesthetist will see you before your surgery on the day and you will have an opportunity to discuss what is best suited for you. The anaesthetic procedure will proceed only after you understand and agree with what has been planned for you. If you have any questions please discuss this in detail with your anaesthetist / surgeon who will be more than happy to address your queries.
A Nerve Block – also called a regional block
This is an injection of local anaesthetic medication in your neck that ‘blocks’ the nerves that go to your shoulder and upper limb numbing them for many hours afterwards. You will not be able to move your arm properly during this time. You may also ask for some sedation to help you relax before a block.
A nerve block is carried out in the anaesthetic room. A plastic cannula is inserted into a vein on your hand to enable us to give you fluids and medications. You are connected to routine monitoring equipment during the procedure. After cleaning the side of your neck with an antiseptic and injecting local anaesthetic to numb the skin, the nerve block is performed. A needle is guided by your anaesthetist with the help of an ultrasound machine to inject the local anaesthetic drug around nerves in your neck area. Ultrasound makes the whole process a lot safer and more effective.
The block generally starts to work within 5 minutes and the surgeon will check and ensure that it is completely effective before commencing the surgery. You may feel some sensation of tugging and pressure but there should not be any sharp pain. The nerve block usually lasts between 4-12 hours (depending on the kind of local anaesthetic injected).
A General anaesthetic
This produces a state of controlled unconsciousness during which you feel nothing. You will receive anaesthetic medications, painkillers, oxygen and sometimes a medicine to relax your muscles. You will also need a breathing tube in your throat whilst you are asleep so the oxygen and anaesthetic gases can move easily to your lungs. When the operation is finished, the anaesthetic is stopped and you regain consciousness.Is it essential for me to have a block?
It is your choice that is made after a discussion with your anaesthetist. There are several alternative methods of pain relief using painkillers that work well; injections given by the nurses. You will also be able to take pain-relieving tablets by mouth. We usually manage to make people comfortable postoperatively.
