Post-Op Pain Service: Peripheral Nerve Blocks

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About Nerve Blocks

Peripheral nerve blocks (or nerve blocks for short) help reduce pain after surgery and are typically very effective. They differ from pain pills by targeting treatment only to the affected body part. Regional anesthesia has been used for many decades, but modern technological advances have improved patient satisfaction, safety, and effectiveness.

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Benefits

• Surgical procedures where the Anesthesiology Physician perfoms a nerve block require less opioid pain medicine, which means a decreased risk of narcotic side effects such as nausea, constipation, dizziness, confusion, and long-term  drug dependence.

• A nerve block typically allows patients to return home more quickly and in a more comfortable state than traditional methods.

 

While often beneficial, nerve blocks are usually optional. You will be able to discuss the subject with your Anesthesiology Physician. Your Surgeon will help you make the decision that best suits you.

 

Information for Patients

If appropriate for you and your surgery, you may receive either a single injection nerve block or a continuous nerve block using an in-dwelling catheter. The following information provides an overview of each.

 

Single Injection Nerve Block

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Information

A single injection nerve block consists of surrounding nerves or other structures with medication which blocks the transmission of pain signals to the brain. A numb area that lasts 6-24 hours after surgery is normal. As the nerve block gradually wears off, you will experience some tingling and return of sensation/motion.

 

Instructions

Be careful with the numb area of your body. Your normal protective mechanisms are impaired, and you could injure yourself. If you had a nerve block of a limb, rest it on a pillow and move it slightly every hour or two.

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Avoid excess heat, cold, or pressure.

 

Take oral pain medication as directed. It is important to take oral pain medication prior to the block wearing off; do not wait until pain is intolerable.

 

You may perform your physical therapy exercises as directed by your surgeon.

 

Nerve Block Catheter & Pain Pump   

A nerve block catheter is a thin tube (called a catheter) which is attached to a pain pump containing numbing medicine (local anesthetic). The pump automatically delivers medicine through the catheter to block the nerves’ ability to transmit pain signals to the brain. Some numbness, tingling, or muscle weakness in the anesthetized area is normal while the catheter is in place, so please remember to avoid excess heat, cold, and pressure.

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Instructions

You may take a sponge bath. Please do not shower or take a tub bath, as you may dislodge the catheter.

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The catheter is held in place by a dressing and taped to your skin. While quite resilient, excessive movement can potentially dislodge it. Once dislodged, it is usually not replaceable. If the dressing appears to be pulling free, you may resecure it with tape. Avoid changing the dressing yourself, as you may inadvertently dislodge the catheter.

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A small amount of dark fluid around the insertion site of the nerve block catheter is normal. You may also see some clear fluid leaking around the catheter site and dressing. Occasional air bubbles in the tubing are common and of no concern.

 

To avoid infection, the catheter should be removed as determined by your Anesthesiology Physician or when the pump is empty (usually post-op day 3).

 

When to Call Your Anesthesiologist

If you experience:

• severe swelling or severe bruising at your nerve block site.

• bleeding, swelling, redness, tenderness, or discharge occurs at the catheter site insertion site.

• confusion, incoherent speech, ringing in the ears

 

Adverse Reactions and Complications

Nerve blocks and in-dwelling catheters are utilized frequently by Anesthesiology Physicians to help reduce pain after surgery.

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Fortunately, adverse reactions and complications are very rare, but may include infection, bleeding, confusion, incoherent speech, ringing in the ears, tingling around the finger tips, allergic reaction or reaction to the local anesthetic medicine, neuropraxia (nerve bruising with an area of residual numbness and/or weakness that may last weeks or months) or, extremely rarely, nerve damage.

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Thankfully, tens of thousands of these nerve blocks have been performed safely and effectively. Your Anesthesiology Physician takes many precautions in attempting to avoid any adverse reactions or complications.