Peripheral Nerve Block

A peripheral nerve block is a medical procedure that involves injecting anesthetic near specific nerves to block sensation in a targeted area of the body. This technique is commonly used for pain management during and after surgical procedures, as well as for chronic pain conditions. This information sheet will explain what it is, Dr. Singer can determine if it is for you.

Here are some of the most common types of peripheral nerve blocks:

Brachial Plexus Block

• Indication: Often used for surgeries on the shoulder, arm, or hand.
• Description: Involves the brachial plexus, a network of nerves that innervates the upper limb. An anesthetic is injected near this nerve cluster to block pain sensation in the arm.

Femoral Nerve Block

• Indication: Frequently used for knee surgeries.
• Description: Targets the femoral nerve, which supplies sensation to the front of the thigh and provides motor function to the quadriceps. This block helps alleviate pain after procedures like total knee replacements.

Sciatic Nerve Block

• Indication: Commonly utilized for surgeries on the lower leg, foot, or ankle.
• Description: This block targets the sciatic nerve, which runs down the back of the leg. It is often performed alongside a femoral nerve block for complete anesthesia of the lower limb.

Axillary Nerve Block

• Indication: Ideal for procedures involving the elbow, forearm, or hand.
• Description: Involves injecting anesthetic near the axillary nerve, which innervates the skin and muscles of the shoulder and upper arm.

Intercostal Nerve Block

• Indication: Useful for thoracic surgery or for managing rib fractures.
• Description: Anesthetic is injected near the intercostal nerves, which run along the ribs, providing pain relief in the chest area.

Popliteal Nerve Block

• Indication: Often used for procedures on the foot and ankle.
• Description: Targets the popliteal nerve, located behind the knee, to provide effective anesthesia for surgeries in the lower leg and foot.

Peripheral Nerve Injections

• Indication: Peripheral nerve injections involve the targeted delivery of medications, such as steroids or anesthetics, directly into specific nerves to alleviate pain and reduce inflammation.
• Description: Often used to treat conditions like neuropathic pain, nerve entrapments, or injuries affecting the nerves in the arms, legs, or other areas.

Saphenous Nerve Injections

• Indication: Involve the targeted injection of anesthetic or steroid medication near the saphenous nerve, which runs along the inner side of the leg and provides sensation to the lower leg and foot.
• Description: Used for conditions such as chronic knee pain, post-surgical pain management, or issues related to varicose veins.

What are the benefits of Peripheral Nerve Blocks?

Pain Relief: Provides targeted pain management, reducing the need for systemic pain medications.

Diagnostic Tool: By temporarily blocking sensation in a specific area, Dr. Singer can help determine the source of pain or confirm a diagnosis. For instance, if a nerve block alleviates pain in a particular region, it may indicate that the pain is originating from that nerve or the structures it innervates. This approach can be especially helpful in cases of complex pain syndromes, guiding further treatment decisions and interventions based on the results.

What are the Risks and Considerations?
While peripheral nerve blocks are generally safe, potential risks include:

• Infection at the injection site
• Nerve damage
• Bleeding
• Allergic reactions to anesthetic agents

What happens during an injection?
A local anesthetic will be used to numb your skin. Dr. Singer will then insert a thin needle directly into space. Fluoroscopy, a type of x-ray, or ultrasound may be used to ensure the safe and proper position of the needle. A dye may be used to make sure the needle is at the correct spot. Once Dr. Singer is sure the needle is correctly placed, the medicine will be injected.

What happens after an injection?
You will be free to get re-dressed and check out at the front desk. Take it easy for the rest of the day. You may feel immediate pain relief and some numbness for a limited time after the injection. This may indicate the medication has reached the right spot. You can usually return to work the day after the injection.

Your pain may return after this short pain-free period or may even be a little worse for a day or two. It may be caused by needle irritation or by the steroid itself. Steroids usually take two or three days to start working, but can take as long as a week.

How long can I expect pain relief?
The extent and duration of pain relief may depend on the amount of nerve inflammation as well as the cause of the nerve pain. Other coexisting factors may be responsible for your pain. Sometimes an injection brings several weeks to months of pain relief and then further treatment is needed. Other times, a single injection brings long-term pain relief. If your pain is caused by injury to more than one area, only some of your symptoms may be helped by a single injection.