If you are scheduled for surgery, you might be surprised when your surgeon or anesthesiologist recommends a nerve block. Here you’ll find out exactly what it is, how it’s done, what the benefits are, and what complications could arise.
Nerve blocks are placed by
anesthesiologists to help minimize or eliminate the pain of surgery. Most often, nerve blocks are performed for orthopedic surgeries and can drastically reduce the amount of discomfort you may have after surgery. This can help speed up the recovery and rehabilitation process.
In most cases, the nerve block is provided
in addition to
general anesthesia. That way, you can be asleep for your surgery and then wake up with less pain.
For example, for major shoulder surgery, your orthopedic surgeon may feel that a nerve block would be beneficial for you. In the usual scenario, the nerve block is placed prior to general anesthesia. So you would have a shoulder that is essentially numb (and pain free) whenever you wake up from your shoulder surgery.
What is a nerve block?
Simply stated, a nerve block is the placement of local anesthetic (eg. lidocaine) and perhaps some additive medicines onto, or near, a nerve or bundle of nerves. This serves to “numb” the area that nerve supplies, decrease/stop the ability to move, and provide pain relief for surgery in that location.
How it’s Done:
Once you have spoken with everyone involved, including your surgeon and anesthesiologist, and all your questions have been answered and your
consent for the “block” obtained, your nerve block can be placed.
Your anesthesiologist gives you “relaxing medicine” through your
IV, places monitors to ensure your safety (eg., blood pressure, EKG, pulse oximetry) and then gets ready to perform the nerve block. There are several techniques to properly locate the nerve(s). The most common in use today include visualization with ultrasound and/or the use of nerve stimulation. Once you are comfortable from the IV medicine, the procedure will begin.
A few moments are spent identifying the correct area of your body where the nerves of interest are located. For the nerves that provide sensation to your shoulder, for example, the nerves are often “blocked” by placing medicine near your neck. For knee surgery, some of the nerves to be blocked are located near your groin.
Once the correct area for the nerve block is identified by the anesthesiologist, numbing medicine is placed into the area. This numbing medicine, or local anesthesia, can last greater than 24 hours in some cases. Alternatively, a nerve block catheter may be placed that will continuously infuse numbing medicine into the extremity for several days of pain relief.
Nerve blocks performed:
We typically perform nerve blocks for surgeries including orthopedic shoulder surgeries of all varieties, carpal tunnel surgery, hand surgery, hip replacements, knee replacements, knee ACL reconstructions, ankle surgeries, and foot surgeries. If you have a fractured extremity, your orthopedic surgeon might ask the anesthesiologist to place a nerve block to help decrease the pain in this extremity as well. Sometimes, nerve blocks can be used as the sole anesthetic for some surgeries, including carpal tunnel surgery and foot surgery. The principle is that if your arm or leg is numb, you don’t experience any pain!
The nerve blocks most commonly used are the interscalene block, supraclavicular block, infraclavicular block, axillary block, lumbar plexus block, femoral block, sciatic block, popliteal block, and ankle block. However, there are other blocks that can be performed depending on your type of surgery.