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Peripheral Nerve Block
What is a peripheral nerve block?
A peripheral nerve block is a minimally invasive procedure that can temporarily relieve pain caused by an injured or inflamed peripheral nerve. A nerve block is normally done on an outpatient basis. You will be positioned on a fluoroscopy (X-ray) or ultrasound table so your doctor can easily access the injection point. These injections typically don’t require sedation, but your doctor may give you a prescription for an oral sedative if needed. Ask your doctor ahead of time if sedation will be used so you can arrange a ride home after the procedure.
You will be given a local anesthetic to numb the area where you will receive your injection. You still may feel a pinch or some discomfort as the needle enters your skin. The doctor will be guided to inject the medication into the right spot using ultrasound or fluoroscopy, which converts X-rays into video images. After the procedure you’ll rest until the medication takes effect.
Note: The procedure cannot be performed if you have an active infection, flu, cold, fever, very high blood pressure or if you are on blood thinners. Please make your doctor aware of any of these conditions. This is for your safety!
What are the risks of the procedure?
As with most procedures, there is a remote risk of bleeding, infection, or allergic reaction to the medications used. Additional short-term effects may occur. You may have some temporary numbness or weakness caused by the local anesthetic (numbing medicine). If this interferes with your ability to walk safely, you will have to remain in the Pain Management Center until it resolves, usually several hours. You may have increased pain for a few days after the injection, including localized pain at the injection site. Diabetics may have short-term elevation of blood sugars as a result of the steroid medication.
How much will the procedure hurt?
Most people say the stinging/burning of the numbing medicine is the most uncomfortable part of the procedure (this lasts only a few seconds); however, every person’s response to any procedure will differ.
How do I prepare for my procedure?
Please check your blood sugar at home before coming in. If you are taking any blood thinners such as Coumadin, Xarelto, Eliquis, Plavix, or any others, these medications must be discontinued well before the procedure. You will be directed by our staff as to when you should stop this medication. Please make your Pain Management doctor aware that you are taking a blood thinner and contact your primary care physician or prescribing physician before stopping this medication.
What happens during the actual procedure?
After the doctor examines you and goes over the risks and benefits of the procedure, he or she will ask you to sign a consent form. Then, you will either be assisted to the X-ray or ultrasound table. Your injection site is cleansed with an antiseptic soap and alcohol, and then covered by sterile drapes. The skin is numbed with local anesthetic (numbing medicine). Using either X-ray or ultrasound guidance, a needle is advanced to the nerve. Local anesthetic (numbing medicine) and possibly steroid are then injected around the nerve, and the needle is removed. The injection site will be washed, and a Band-Aid will be applied. You will be monitored for an appropriate time in the recovery area (usually 10-20 minutes) where you may be offered juice/soda and graham crackers. You will be given verbal and written discharge instructions and may go home with your driver after your doctor authorizes discharge.
How will I feel after the injection?
Your pain may be improved immediately after the injection from the local anesthetic. Once the numbing medicine wears off, your pain may return. It is possible that you will have some soreness at the injection site and your pain may worsen for a day or two after the procedure. The steroid medication takes 2-3 days to start having an effect in most people. Using an ice pack applied three or four times a day can help alleviate the discomfort at the injection site. You may take your usual pain medication after the injection.
Will I have restrictions on the day of the procedure?
No heat is to be used in the injected area for the remainder of the day. No tub bath, shower or soaking in water (i.e., pool, hot tub, etc.) for the remainder of the day. You may resume normal diet and medications after the procedure unless told otherwise by your doctor.
When should I call the Pain Management Center?
We would like you to schedule a follow up appointment 1-2 weeks after your procedure regarding your response. Specifically, we would like to know if you experienced pain relief (if so, how long did it last), your current pain score, and if you are experiencing any problems. If you experience severe pain, new numbness or weakness of your legs, a temperature of 100.5 or greater, or signs of infection in the area of the injection (redness, swelling, heat, discharge), you should call the Pain Management Center immediately at 702-982-1300 to have the pain management physician on call paged to your number.