What is Peripheral Nerve Block

Peripheral nerve block is an injection of numbing medicine (regional anesthetic) near a nerve. The regional anesthetic numbs everything below the injection site. This provides pain relief during and after a medical procedure.

Generally, you will be awake while a peripheral nerve block is performed. You also may receive medicines to help you feel relaxed and comfortable during the procedure (sedatives).

When you have a peripheral nerve block, you are not exposed to the risks associated with medicine that makes you fall asleep (general anesthetic). You may also:

• Need less pain medicine after your procedure.
• Have a lower risk of blood clots.
• Recover sooner.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines.
• Damage to other structures or organs, such as temporary or permanent nerve damage.

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

General instructions

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
  • Taking over-the-counter medicines, vitamins, herbs, and supplements.
• Plan to have someone take you home from the hospital or clinic.
• Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic. This is important.

What happens during procedure?

• An IV will be inserted into one of your veins.
• You may be given a sedative.
• Your nerve may be located by using:
  • Sound waves that create images of the area (ultrasound).
  • A device that activates the nerve and causes your muscles to twitch (nerve stimulator).
• The skin around your injection site will be cleaned with a germ-killing solution.
• Medicine to numb your injection site (local anesthetic) may be injected into the tissue above your nerve.
• Regional anesthetic will be injected into the area near your nerve.
  • The medicine will be injected around the nerve, not into it.
  • You should not feel any pain. The area of your peripheral nerve block will begin to feel warm and numb.
• A thin, flexible tube (catheter) may be inserted near your nerve. The catheter may remain there to continue delivering the regional anesthetic during and after your medical procedure.
• When the area of your peripheral nerve block is completely numb, the medical procedure can be performed.
• Your injection site may be covered with a bandage (dressing) when your medical procedure is done.

The procedure may vary among health care providers and hospitals.

What can I expect after the procedure?

• If you do not have a catheter, you may continue to be numb for up to 24 hours. The length of this time depends on how much anesthetic was injected.
• If you have a catheter, you will continue to be numb until the catheter is removed.
• To reduce your risk of injury:
  • Do not expose the numb area to heat or cold.
  • Do not stand up or try to walk without help if you have a nerve block in one or both legs. Get help and limit your activity as told by your health care provider.
• As the medicine wears off, you will have a gradual return of feeling in the area that is supplied by the nerve.
• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.

Follow these instructions at home:

Activity

• Do not drive for 24 hours if you were given a sedative during your procedure.
• Do not lift anything that is heavier than 10 lb (4.5 kg), or the limit that you are told, until your health care provider says that it is safe.

Injection site care

• If you have a dressing, remove it 24 hours after your procedure, or as told by your health care provider.
• Check your injection site every day for signs of infection. Check for:
  • Redness, swelling, or pain.
  • Warmth.
  • Fluid or blood.
  • Pus or a bad smell.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not take showers or baths, swim, or use a hot tub until your health care provider approves.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You continue to have numbness, weakness, or tingling after your medicine has worn off.
• You have a fever.
• You have redness, swelling, or pain around your injection site.

Summary

• Peripheral nerve block is an injection of numbing medicine (regional anesthetic) near a nerve. This provides pain relief during and after a medical procedure.
• Feeling will gradually return to the area that is supplied by the nerve.
• A catheter may be inserted to continue to provide medicine for up to several days.