Peripheral nerve injections

Peripheral nerve blocks (PNB) are widely-used for surgical anesthesia as well as for both postoperative and nonsurgical analgesia. PNBs offer distinct benefits over general or neuraxial anesthesia in certain clinical situations. In addition, PNBs provide analgesia that may be superior to other techniques for some patients.

Upper extremity blocks:

Interscalene block

Supraclavicular block

Peripheral Nerve Blocks

Peripheral nerve blocks play an important role in the anesthetic plan for patients undergoing many types of surgical procedures. A peripheral nerve block is accomplished by injecting a local anesthetic near the nerve, or nerves, that control sensation and movement to a specific part of the body. This injection will temporarily numb the area in question, resulting in a number of benefits.

Peripheral nerve blocks are typically performed for surgeries of the upper or lower extremities but can also be used for surgeries around the neck (e.g. carotid artery endarterectomy) or groin (hernia).

Alternative, when appropriate, to general anesthesia and central nerve blocks

Peripheral nerve blocks give us an alternative to general anesthesia and central nerve blocks for surgery. In some cases, especially for patients with more serious medical issues, peripheral nerve blocks are safer than general or spinal anesthesia. In many cases, peripheral nerve blocks are preferred due to their distinct advantages-they significantly reduce the risk of post-operative fatigue/confusion, as well as dramatically reduce the incidences of nausea and vomiting. Additionally, the use of peripheral blocks, in comparison to central blocks, restricts the numbed area to the specific site of the surgery, or to one extremity, as opposed to numbing both legs. Further advantages include better post-operative pain control (limiting the need for strong pain medications, which have complications of their own), earlier discharge from the recovery room and hospital and improved patient satisfaction. Patients who have had peripheral nerve blocks tell our doctors they sleep better after leaving the hospital and recover more quickly from surgery.

Peripheral nerve blocks allow for reduced medication during surgery

In many cases, even when another anesthetic (general or regional) is necessary for adequate surgical anesthesia, a peripheral nerve block performed pre-operatively will allow us to give a greatly reduced dosage of medications during the operation itself. Anesthesiologists time the injection so that by the end of the surgical procedure, the peripheral nerve block is in full effect. This allows the patient to go home sooner than would otherwise be possible and with excellent pain relief since the numbness that results from the block will generally last from 12-24 hours, and in some cases, up to several days.

Peripheral nerve blocks, or local anesthetics, and the duration of pain relief

The duration of pain relief from peripheral nerve blocks is related both to the choice of medication used, as well as to how it is delivered. Some local anesthetics have longer duration than others and your anesthesiologist will be able to tell you what to expect depending on specific factors related to your individual case. Another factor influencing the duration of pain relief is the decision to administer a single shot injection of local anesthetic or place a catheter next to the nerve, which will deliver numbing medicine continuously for a period of days.

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