Advice after your nerve block for surgery
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Introduction
Epistaxis: is bleeding from the nose. Sometimes the blood runs into the back of the throat from the nose.
In young people the bleeding is usually from the front part of the nasal septum, the partition inside the nose.
In older people, the bleeding can occur from further back inside the nose. A nose bleed can occur spontaneously or there are certain specific causes,
for example:
- Injury to the nose
- Nasal infections, such as the common cold
- Following nasal surgery
- High blood pressure
- Blood clotting abnormalities, including
- medication, e.g. Aspirin or Warfarin
- Abnormalities in blood vessels themselves
Treatments
Most nose bleeds can be stopped by simple first aid measures. Whilst sitting up, apply pressure to the front of the nose by gently squeezing the tip of the nose between the thumb and forefinger for around 5 minutes.
Cold compresses around the nose and face may also help. If you feel faint, lie down with the bleeding side of your nose uppermost. If a nose bleed continues for more than 30 minutes, then it is advisable to seek medical attention.
If the bleeding is from the front of the nose, the bleeding point can be cauterised with silver nitrate, or an electric current, under local anaesthetic. If the bleeding is from further back in the nose, it is often possible to visualise the bleeding vessel with an endoscope, which enables cautery. In certain instances, when a bleeding point cannot be identified, or the bleeding is too profuse, the nose has to be packed with either a sponge or gauze impregnated with an iodine containing material.
On occasion, if the bleeding is from the back of the nose, a catheter is inserted into the back of the nose via the nostril and the balloon inflated with water. In addition, the front of the nose may also be packed. The nose may sometimes need packing on more than one occasion. If packs are placed in the nose, admission to hospital is advisable.
It may be advisable to stop Aspirin or Warfarin medication for a while: this is usually done in consultation with a physician. For minor nose bleeds, an antiseptic cream placed into the nose for 10 days is often helpful.
Difficult cases
The majority of nose bleeds respond to either chemical or electric cautery or nasal packing within 24 hours. If the nose continues to bleed, then the patient is taken to the operating theatre and the nose examined under a general anaesthetic. If a bleeding point is identified, this can be cauterised.
If the nasal septum is very bent inside the nose, this can be straightened. On occasion, it is necessary to clip a small vessel in the back of the nose, which is the main arterial supply to the nose. Very rarely, both of these vessels are clipped and in addition vessels entering the nose from the eye
may also be clipped.
In the majority of cases, these measures are successful, but extremely rarely it is necessary for further surgery to stop the bleeding, which may include the ligation of an artery in the neck.
After a Nose Bleed.
Following a significant nose bleed, it is advisable to do the following:
- Rest as much as possible
- Do not touch, pick or blow the nose
- Keep hot drinks to a minimum
- Avoid straining when going to the toilet
- Avoid heavy lifting
- Avoid spicy foods
If any of these problems arise after you have gone home please contact the wards:
Frimley Park Hospital: Short Stay Surgery ward Direct No: 0300 613 3216
F1 (children’s ward) 0300 613 4252
Sources of Additional Information:
British Association of Otorhinolaryngologists:
- www.
- www.entpartnership.co.uk
- www.nice.org.uk
Contact us
If you have any queries relating to this information, please contact the Ear or nose and throat (ENT) service.
About this information
Service:
Ear, nose and throat (ENT)
Reference:
G/022
Approval date:
23 February 2026
Review date:
1 February 2029
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Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.