Aims and objectives. The aim of this study was to show what the experience of local anaesthesia and a surgical situation meant to patients. Background. Many patients who receive local anaesthesia will remain awake during surgery. The very fact of staying awake causes psychological and psychosocial needs. These needs must be met and it is therefore important to identify them. Design/method. Seven patients (aged 61–79) experiencing local anaesthesia and hip surgery (hip replacement surgery or repair of fractured hip) were interviewed. An interpretive phenomenological method developed by Benner was used to extract the experience of what it means to be in local anaesthesia and surgery. One paradigm case is used to illustrate the results. Results. Results show that the well-being and comfort of patients is compromised by challenges such as severe pain and long waits, which may be experienced as endless and which leave the patient thinking of nothing else. By contrast, the experience of trust helps the patient to feel control even in situations where the treatment is hard to grasp. Conclusions. The results highlight that local anaesthesia and surgery force patients to overcome and handle experiences of pain, trust and distrust as well as feelings of alienation and unreality. Relevance to clinical practice. The results illustrate the patient’s needs, as seen from the patient’s perspective. A shared experience makes it possible to understand, and thus to recognize, the required qualitative care to facilitate and to help the patient to remain in control and face the psychological challenges presented by anaesthesia care and surgical