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Regional Nerve Blocks
Nerve blocks are administered to block pain signals traveling through a single nerve bundle when a smaller area of the body, such as one arm or one leg, needs to be made numb. Nerve blocks may be appropriate for use during the operation or for post- operative pain control. After numbing the skin, a needle is placed near the nerve bundle and local anesthesia is injected through the needle or catheter. This anesthetizes the nerves and interrupts the transmission of sensation and motor control, resulting in numbness and muscle relaxation of an arm, hand or leg.
The more widely used approaches are:
- Axillary Block
Axillary block is arguably the most widely taught and thus most frequently used approach to the brachial plexus. It involves an injection of local anesthetics into the axilla, or armpit. Axillary block is usually used for surgery on the hand. There are a variety of techniques used to precisely locate the nerves in order to place the anesthetic solution in just the right spot.
- Supraclavicular Block
This is performed by inserting the needle just behind the collarbone, or clavicle. It is a often used for surgery or pain control of the elbow.
- Interscalene Block
This approach is very similar to the supraclavicular block but differs in that the site of injection is closer to the base of the neck. It is sometimes used for post-op pain management following surgery on the shoulder or as a supplement to general anesthesia during shoulder surgery.
- Bier Block
A special type of nerve block called an IV block or Bier block can be used for limited operations to numb one arm. A second IV is placed in the operative arm and a tourniquet (like a small blood pressure cuff) is wrapped around the upper arm. After inflating the tourniquet, local anesthesia is injected through the IV to numb the arm below the tourniquet.
- Femoral Nerve/Sciatic Nerve/Popliteal Nerve Block
These nerve blocks numb certain areas of the knee and ankle and can be used for the particular surgery itself or to aid in pain control after the surgery is over.
It should be noted that the patient is often sedated prior to placement of the nerve block.
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