Patient education: Nerve blocks (The Basics)

What is a nerve block? — This is a type of anesthesia that can be used to help with pain. A doctor gives medicines near 1 or more nerves to block pain in a specific area of the body.

Nerve blocks can be used to treat:

●Acute pain – This is pain that lasts for a short period of time. It often happens after an injury or a surgery. Doctors often use different ways to help with pain during and after surgery. Sometimes, using nerve blocks can help a person need less pain medicine. This can be helpful because "opioid" medicines come with risks, so doctors try to limit their use.

●Chronic pain – This is pain that lasts longer than a few months. Nerve blocks can be used to treat chronic pain. They might also help the doctor find where the pain is coming from and make a treatment plan.

There are many kinds of nerve blocks. For most, the numbing medicine works right away. But sometimes, the doctor also adds other medicines. These can help pain relief last longer. These medicines can take a few days to give their full effect. Some nerve blocks only last for a few hours or for a day. Others last a few months or longer.

Nerve blocks might be given by a doctor called an "anesthesiologist." Sometimes, other doctors or a "nurse anesthetist" will give a nerve block. A nurse anesthetist is a nurse with special training in anesthesia.

What happens before a nerve block? — Before any kind of nerve block, the doctor will meet with you and do an exam. They will also ask you about your "health history." This involves asking you questions about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:

●Any medicines you are taking – This includes any prescription or "over-the-counter" medicines you use, plus any herbal supplements you take. It helps to write down and bring a list of any medicines you take, or bring a bag with all of your medicines with you.

●Any allergies you have

●Any bleeding problems you have – Certain medicines, including some herbs and supplements, can increase the risk of bleeding. Some health conditions also increase this risk.

You will also get information about how to prepare for your procedure. This includes:

●Eating and drinking – For some types of nerve blocks, you need to "fast" before surgery. This means not eating or drinking anything for a period of time. In many cases, you do not need to stop eating or drinking before the nerve block.

●What help you will need when you go home – For example, you might need to have someone else bring you home.

Ask the doctor or nurse if you have questions or if there is anything you do not understand.

What happens during a nerve block? — When it is time for the procedure:

●You might get an "IV," which is a thin tube that goes into a vein. This can be used to give you fluids and medicines.

●The doctor might give you a "local anesthetic." This is medicine to numb the area where the needle goes in. They might also give you medicines to make you relax and feel sleepy, called "sedatives." Nerve blocks can also be combined with other types of anesthesia for surgery.

●The doctors and nurses will monitor your breathing, blood pressure, and heart rate during the procedure.

●The doctor will put you in the right position.

●They will clean your skin and give you medicine to numb the area.

●They will use a needle to do the nerve block. To make sure the needle is in the correct place, they might:

•Locate nearby structures like bones, tendons, or blood vessels

•Use a "nerve stimulator," which uses small amounts of electricity to make the nerve react

•Use imaging, like ultrasound or fluoroscopy (a moving X-ray)

●Once the needle is in the correct place, the doctor will inject medicines close to the nerve that is causing the pain. Sometimes, they will inject medicine in an area that will block pain from a few nerves.

●In some cases, the doctor might leave a thin tube, or "catheter," in place. This is a way to keep giving medicines over 1 to 2 days. You might need to return to the doctor's office to have the catheter removed.

●The doctor will remove the needle and place a clean bandage over the area.

●The procedure takes 15 to 30 minutes.

What happens after a nerve block? — If you are not having surgery, you can go home the same day. You might be asked to rest for 15 to 30 minutes after the nerve block. If you were given medicine to make you sleepy for the procedure, you will need someone to bring you home.

As you recover:

●You can shower or take a bath later that day, unless you still have a catheter.

●You might need other pain medicines to help control your pain after the nerve block wears off.

What are the risks of a nerve block? — Your doctor will talk to you about all of the possible risks, and answer your questions. Possible risks include:

●Infection

●Bleeding or bruising

●Nerve injury

●Injury to a nearby organ

●Allergic reaction

What else should I know? — Before you go home, make sure that you know what problems to look out for and when you should call the doctor. Make sure that you understand your doctor's or nurse's instructions. Ask questions about anything you do not understand.

More on this topic

Patient education: Anesthesia (The Basics)
Patient education: Sedation for procedures in adults (The Basics)
Patient education: Managing pain after surgery (The Basics)
Patient education: Chronic pain (The Basics)