Started during op forCarpal Tunnel when local didn't work, felt every cut but kept my mouth shut and didn't give a sign the fourth cut pain was so bad I jerked up and only my head and toes were touching the table. Left hand clenched into fist and shot up into the air. right must have tried to do the same and broke against the clamp, both surgeon and 50 visits to hand therapiasts didn't see it. RSd real bad within 8 hours.