The brachial plexus is the major nerve bundle going to the shoulder and arm. Depending on the level of surgery, your anesthesiologist will decide at what level he wants to block the brachial plexus. For example if you have surgery at the shoulder, your anesthesiologist may choose a nerve block interscalene or cervical paravertebral block performed at a location above the clavicle. For surgeries below the shoulder joint or clavicle, an infraclavicular or axillary technique may be used.
Your anesthesiologist may use ultrasound, a nerve stimulator or other techniques to help identify the appropriate location along the brachial plexus to inject the local anesthetic.
If a nerve stimulator is used, you may feel the muscles in your shoulder or arm twitch. If you experience any sharp pain or any type of paresthesia "shock-like" sensation similar to if you were to hit your "funny-bone" in your elbow shortly before or during the injection you should notify your anesthesiologist immediately. You should also notify your anesthesiologist before performing any brachial plexus block if you have any type of pain below the elbow, preexisting pain, or preexisting nerve injury.
If you have serious respiratory lung, breathing problems you should notify your anesthesiologist before proceeding with the block. Your anesthesiologist will then decide whether a brachial plexus block is safe for you and will provide adequate analgesia for the surgery.
Paravertebral blocks can be utilized to numb a specific area in one part of the body depending on where the block is performed. For example, paravertebral blocks at the level of the neck can be used for thyroid gland or carotid artery surgery.
Paravertebral blocks at the level of the chest and abdomen can be used for many types of breast, thoracic, and abdominal surgery. Paravertebral blocks at the level of the hip can be used for surgeries involving the hip, knee, and the front of the thigh. In general, all paravertebral blocks are performed with a similar technique.
Your anesthesiologist will feel your back, clean your skin with an antiseptic bacteria-killing solution, and may inject some local anesthesia into the skin and then into the deeper tissues of the back - this may cause a slight burning or pressure sensation.
Your anesthesiologist will then carefully insert and advance a needle and inject local anesthesia to numb the nerves. If a nerve stimulator is used to help locate the nerves, you may feel the muscles in your chest, abdomen, or legs twitch.
If paravertebral blocks are utilized for thoracic and abdominal surgery, more than one injection may be needed to provide achieve adequate anesthesia. The needle is removed and only the catheter remains at the end of the procedure if this is the case. As with other blocks, always let your anesthesiologist know if you experience any sharp or radiating pain during the procedure or injecting of the local anesthetic.
Always notify your anesthesiologist if you experience sudden numbness, bilateral numbness or warmness with the injection of your local anesthetic. The femoral nerve provides sensation and motor function to the front of the thigh and knee. This block is commonly used for procedures that cover the knee. If you receive a femoral nerve block, you will be positioned on lying on your back. Your anesthesiologist will clean your groin area with an antiseptic bacteria-killing solution.
If using an ultrasound, the anesthesiologist will place the ultrasound probe on your skin. An image of the femoral nerve will be obtained by scanning the area. Your anesthesiologist will then carefully insert and advance a needle toward the femoral nerve. The ultrasound is used to visualize the needle as it approaches the nerve.
The needle does not touch the nerve; it is stopped when it is near the nerve. Once the needle is in proper position relative to the nerve, local anesthetic is injected through the needle to numb the nerve. The local anesthetic can be seen surrounding the nerve with ultrasound. Sometimes a nerve stimulator is also used to help your anesthesiologist determine the appropriate location to inject the local anesthetic. If a nerve stimulator is used, you may feel the muscles in your leg twitch—this is normal.
You may have difficulty with weight bearing on the blocked leg, and you should have help in attempting to get up. Care should be taken to prevent falls. This sciatic nerve provides sensation and motor function to the back of the thigh and most of the leg below the knee.
This block is commonly used for surgery on the knee, calf, Achilles tendon, ankle, and foot. If you receive a sciatic nerve block, you generally will be place on your belly or side but occasionally you may be lying on your back. Your anesthesiologist will clean your skin with an antiseptic bacteria-killing solution. An image of the sciatic nerve will be obtained by scanning the area. Your anesthesiologist will then carefully insert and advance a needle toward the sciatic nerve.
A nerve stimulator is sometimes used as well to help your anesthesiologist determine the appropriate location to inject the local anesthetic. You may feel the muscles in your leg twitch—this is normal. Regional Anesthesia for Surgery. Risks and Benefits. Learn More. Pain Relief After Surgery. Important Phone Numbers. Top of the page. Topic Overview Regional anesthesia is the use of local anesthetics to block sensations of pain from a large area of the body, such as an arm or leg or the abdomen.
Major types of regional anesthesia include: Peripheral nerve blocks. A local anesthetic is injected near a specific nerve or bundle of nerves to block sensations of pain from the area of the body supplied by the nerve.
Nerve blocks are most commonly used for surgery on the arms and hands, the legs and feet, the groin, or the face. Epidural and spinal anesthesia. A local anesthetic is injected near the spinal cord and major nerves that enter the spinal cord to block sensations of pain from an entire region of the body, such as the lower abdomen, the hips, or the legs. Regional anesthesia is most often used when the procedure: Is confined to a specific region of the body.
Involves a large area of the body where injection of large amounts of an anesthetic might cause side effects that affect the entire body. Does not require general anesthesia. Risks and complications from regional anesthesia For regional anesthesia, an anesthetic is injected close to a nerve, a bundle of nerves, or the spinal cord.
Related Information Anesthesia. Credits Current as of: May 27, Current as of: May 27, Home About MyHealth. Guheen, MD, explains regional anesthesia. This is part of the video series, Anesthesia Frequently Asked Questions. Combination Spinal-Epidural Anesthesia. Regional Anesthesia. Back in the Game patient stories. Blog posts.
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