The interscalene block is meant to target the brachial plexus, a network of nerves sectioned between two scalene muscles. These nerves send signals from the spine to the shoulder, arm and hand.
To identify the area, the anesthesiologist will trace your nerves with a marker on your skin. Once they identify the nerves, they will attach a small needle to a handheld nerve stimulator in order to guide the numbing medication to the brachial plexus nerves.
The handheld stimulator will cause a slight muscle contraction in the biceps or shoulder once the nerve has been activated. This muscle twitch does not cause any pain. When the needle is in the appropriate position, the anesthesiologist will administer the numbing medication and remove the needle. Some anesthesiologists use ultrasound to help guide placement of the needle. In these cases, a small amount of gel is placed on the skin and a transducer, or wand, is moved over the area.
There is no discomfort; the only sensation is that of the transducer moving over the skin. You will first notice a numbing sensation in the arm, shoulder, and fingers.
The interscalene block will begin to take effect anywhere from 5 to 30 minutes after being administered, depending on the numbing medication used. The two common medications used are lidocaine , which is used for its quicker effect, and bupivacaine , which is used to prolong the numbing effect.
It allows better blood pressure control, less bleeding, and ultimately more patient comfort, while reducing the incidence of episodes of dangerously slow heart rates. Ultimately, your level of sedation is the decision of your attending anesthesiologist.
At the end of surgery, when the sedation wears off, you will notice a few things. These are normal experiences, and they will disappear as the block wears off.
As with any anesthetic, there are risks and benefits to interscalene blocks. These particulars can be discussed with your anesthesiologist before your surgery. The risk of infection is very low as the procedure is done in a sterile manner. Will having a nerve block hurt? Nerve blocks involve placing a needle smaller than an IV near the nerves that supply the part of your body being operated on.
We give all patients sedating medicine when we do the nerve block to help you relax. Will I be awake during the operation? After a nerve block, the part of your body that will be operated on will be numb. Many times it is your choice to be as awake or asleep as you want. You never get to see the surgery itself because a large sterile drape is always placed between you and the surgeon.
How long will the nerve block last? This depends on the type of block performed and the type of numbing medication used. For example, nerve blocks for hand surgery usually last for hours, but a nerve block for pain after total knee replacement can last for hours.
Medication continuously delivered through a tiny plastic tube nerve catheter placed next to the nerve can last for days. How is the block done? Vicodin or Percocet and anti-inflammatory medications e. Ibuprofen or Aleve as soon as oral medications are tolerated. These medications should be taken on a scheduled basis as soon as you start feeling tingling in your arm or fingers. The tingling sensation means the block is starting to wear off.
This will allow for a smooth transition from the nerve block to oral medication based pain relief. You should take caution to not come in contact with extremely hot or cold items because you will not be able to protect yourself from injuries of extreme temperature.
Shortness of breath — The injection in the neck can also numb half of the diaphragm a muscle used in breathing. Some people can feel slightly short of breath, although in most individuals this does not greatly affect the ability to breathe adequately. Blurred vision — Numbing of a nerve traveling to the face can cause a drooping eyelid, change in pupil size, and slightly blurred vision on the side of the block.
0コメント