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  1. 8219-Plexus anaesthesia (EN)

Plexusanesthesie

You will be operated on soon. For this operation, you will receive local anaesthesia in the form of plexus anaesthesia. This anaesthetic is used in operations on arms, legs and shoulders. The anaesthetist temporarily switches off the nerve plexus or node in your arm, leg or shoulder. However, you remain conscious. If you wish, you can get a sedative so that you sleep during the operation and are unaware of the surgery. To ensure that the operation runs smoothly, it is important that you read this folder carefully. You may not, for example, eat or drink before the operation. Sometimes it is also necessary to stop taking your medication.

No eating or drinking before the operation

Your stomach must be empty for the operation. If you eat, stomach acid is produced. Under anaesthesia, this stomach acid can enter the lungs which may cause pneumonia. To prevent this, your stomach must be empty for surgery. This means that you may not eat or drink from a certain time. If you do eat or drink before the operation, the operation cannot take place.

No eating or drinking before the operation. This means:

Up to 6 hours before the admission time you may have a light meal only. You can choose from:

  • 2 rusks/crackers with jam, no butter or;
  • 1 slice of bread with jam, no butter.

Up to 2 hours before the admission time you may only drink clear liquids such as:

  • coffee (without milk, sugar is allowed), tea, water, clear apple juice or uncarbonated lemonade;
  • you may not drink dairy products or broth.

In the diagram below on the left side, you can find the time you are expected at the hospital (this is your admission time). Behind it, you can see from which time you may no longer eat and also from which time you may no longer drink.

Table schedule for eating and drinking
Admission time
(this is the time you need to be at the hospital)
You may not eat from: You may not drink from:
08.00 02.00 06.00
09.00 03.00 07.00
10.00 04.00 08.00
11.00 05.00 09.00
12.00 06.00 10.00
13.00 07.00 11.00
14.00 08.00 12.00
15.00 09.00 13.00
16.00 10.00 14.00

Please note:
If you are admitted the day before your operation, you do not have to arrive with an empty stomach.

Can I take my medication before the operation?

If you are taking medication, the anaesthetist will discuss whether you can take it or if you must stop temporarily. If you take blood thinners, you may have to stop a few days before the operation. Your anaesthetist or the Thrombosis Service will tell you when to stop taking your blood thinners and when you can start again.

Shortly before the operation, we check if your health or medication use has changed. If your operation takes place at Isala Zwolle, you will receive a short list of questions on the day of your admission. If your operation takes place at Isala Meppel, we will call you one day before your admission.

The operation

You get painkillers about an hour before the operation. Then you are taken to the preparation room in the Operating Theatre where you are connected to various monitoring devices. You get an infusion in your arm to administer fluids and medication.

The anaesthetist determines the right spot for anaesthesia with an ultrasound device. Once the needle is in the right place, the anaesthetist will inject the anaesthetic. A short time later you will notice that your arm or leg is tingling and getting warm. Then the feeling disappears and you can no longer move your arm or leg. The anaesthetic takes about 15 to 30 minutes to start working before the effect is optimal. Then you go to the operating room.

You are awake during the operation. If you would prefer to sleep, ask for a sedative. Even if you are awake, you will not see the operation. The surgical area is blocked off by a screen.
If your shoulder is being operated on, you often get plexus anaesthesia in the form of an injection in the throat or neck. This is mainly for pain relief after the operation. You will also receive narcosis before the operation. More information about narcosis can be found in the folder General Anaesthesia (narcosis).

After the operation

After the operation, it can take 6 to 8 hours for the anaesthetic to wear off. Sometimes it takes 12 to 24 hours. You will notice that it is wearing off when the anaesthetised arm or leg starts tingling. The movement comes back first and then the feeling.

After plexus anaesthesia of an arm, you do not have to stay in the hospital until the anaesthetic has worn off. If and when you can go home depends on the operation. As long as the arm is numb, it remains in a sling.

Pain relief after the operation

It is important that you suffer from as little pain as possible after your operation. As soon as the anaesthetic starts to wear off, you must start with the prescribed painkillers (paracetamol, ibuprofen or diclofenac). The nurse will give you advice on this when you are allowed to leave the hospital.

Side effects and complications

After the anaesthetic has worn off, your arm and hand may still tingle for a while. This is due to irritation of the nerves (from the injection) or from the medication used. The tingling usually disappears within a few weeks or months.

Even though the anaesthetic is injected around a nerve, it eventually ends up in your bloodstream. It must then be broken down by your body. If there is a lot of anaesthetic in your blood, you may experience a metallic taste in your mouth, tingling around the mouth, a drowsy feeling or tinnitus. In very rare cases, it can lead to cardiac arrhythmia or a loss of consciousness. Because you are constantly monitored during and after the procedure, these complications are easy to treat.

Going home

After you have had plexus anaesthesia, your reflexes may be temporarily affected. If you are allowed to go home on the day of the operation make sure that you are not alone at home the first night after your discharge from the hospital. You may not drive home yourself. Make sure you have someone to take you home. You may also not operate dangerous machinery that day, and you should not make any important decisions.

Take it easy at home for the first 24 hours after the operation. Make sure you have enough painkillers such as paracetamol, ibuprofen or diclofenac at home. Please also follow the instructions given to you by the doctor who operated on you.

It is quite normal that you will not feel fit for some time after an operation. This is not only because of the plexus anaesthesia but also because an operation is a major event. The body must recover at its own pace.

Contact

If you have any questions, you can call the location where you are being treated:

Zwolle

Preoperative Examination
(038) 424 21 39 (available from Monday to Friday between 8:30 and 17:00)

Meppel

Admissions Service Point
(0522) 23 30 16 (available from Monday to Friday between 8:30 and 17:00)

If you can't make it, please let us know so we can make a new appointment.

8 mei 2019 / 8219

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