What is a Nerve Block?
A nerve block is the injection of numbing medication (local anesthetic) near specific nerves to decrease your pain in a certain part of your body during and after surgery.  For specific types of surgery, your anesthesiologist may place a “nerve catheter,” which may be used to continuously bathe the nerves in numbing medication for 2-3 days after the surgery.  A nerve block is not for everyone and your anesthesiologist will evaluate whether it is the right option for you.

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Why should I have a nerve block?
A nerve block decreases your pain during and after surgery.  It is more effective than pain medications through the IV.  Because you have less pain, you will need less oral or IV pain medications, even though you have the medications available to you.  You will have fewer side effects of pain medications, such as respiratory depression, itching, nausea, and somnolence.  In addition, you may be able to avoid a general anesthesia.   Sometimes, a nerve block is done in addition to a general anesthesia for pain relief after the surgery.

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Is a nerve block safe?
Like general anesthesia, nerve blocks involve some minor risks. The risk of infection is very low as the procedure is done in a sterile manner.  There is an extremely low risk (<0.1%) of injury to nerves, and this is usually temporary.

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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.

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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.

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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 6-8 hours, but a nerve block for pain after total knee replacement can last for 12-24 hours. Medication continuously delivered through a tiny plastic tube (nerve catheter) placed next to the nerve can last for 2-3 days.

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How is the block done?
At BJC, the nerve block is done predominantly under ultrasound guidance, which is the most modern technique.  This technique allows us to see the needle direction and local anesthetic injection in “real time”.

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How long will the block take?
Usually a single nerve block takes 5-10 minutes to do. It takes another 15-20 minutes to start working fully. We always make sure the block is working before you go into the operating room.  Again, you will be given some sedation medicine to help you relax when we do the block.

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Will I get the nerve block in the operating room?
No. We do the nerve blocks in the pre-operative area before your surgery. This lets you have the block done in a quiet place before you are moved to the operating room for surgery.

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If I don’t have the block, will I have pain?
We will use IV opiates (morphine-like drugs) to control your pain during and after surgery.  These drugs have side effects and may or may not be as effective as a nerve block.  IV pain medications will be available to you even if you have a nerve block for break through pain.

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Do I have the right to refuse the block?
Yes. We can only tell you about your options. We will advise you to have surgery with a nerve block if we think it provides the best anesthetic conditions with the least side effects.  In some rare situations, general anesthesia may be riskier compared to having surgery with a nerve block. In these specific cases, we would strongly advise you to have a nerve block for surgery.

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