Our goal is to keep you safe and comfortable, help you recover faster, and lower the need for strong pain medicines like opioids.
The Regional Anesthesia and Acute Pain Service is a collaborative team within the Department of Anesthesiology at WashU Medicine and Barnes-Jewish Hospital. Our team consists of specialized anesthesiologists, fellows, residents, and nurses who works together to provide expert nerve blocks and personalized pain management tailored to your surgery.
What is a Nerve Block?
A nerve block is a way to help control pain after surgery. Your doctor places numbing medicine near certain nerves so pain signals from the surgery area do not travel to the brain.
- Plexus Blocks: A technique performed by injecting numbing medicine next to the nerves to block limbs (shoulders, arms, hands, legs, feet, etc.).
- Fascial Plane Blocks: A technique performed by injecting numbing medicine between layers of muscles to block nerves of chest, belly or back.
- Techniques: The block may be applied as a single-shot or continuous catheter technique.
- Anesthesia Integration: Blocks can be used together with general anesthesia, or sometimes as the main type of anesthesia.
- Timing: These are usually performed while you are relaxed or lightly asleep.
Why do we recommend Nerve Blocks?
Nerve blocks are one of the best ways to control pain right after surgery. Benefits include:
- Better pain control and easier participation in physical therapy.
- Less need for opioid pain medicine.
- Lower chance of side effects like nausea and vomiting.
- Faster recovery, which may help you go home sooner.
- Safety: Can be safer for patients with certain medical conditions or allergies.
The Procedure: What to Expect
Before Surgery
Most blocks are performed in the holding area before surgery, though some may be placed afterward in the recovery area if needed. Before we begin, the anesthesia team will review your medical history, explain the procedure once more, and answer any questions.
Patient Safety Time Out
During this time, we will ask you to confirm your:
- Name and Birthday
- Type of Surgery
- Surgical Side
During the Procedure
In a comfortable position, you are given relaxing medication and your skin is cleaned. We use ultrasound guidance to help safely place the numbing medication near the targeted nerves.
Timing
- Performance: A single block takes 5–10 minutes; a continuous catheter takes 20 minutes due to a longer setup period.
- Effect: It takes another 15–20 minutes for the block to fully take effect.
Protecting the Numb Area
Until feeling returns, you must take these precautions to avoid injury:
- Temperature: Avoid heating pads, ice packs, or very hot/cold temperatures (you may not feel a burn).
- Safety: Be careful around sharp objects; you may not feel an injury.
- Support: Use a sling or brace if your care team recommends one.
- Mobility: If your leg is numb, use extreme caution and ask for help when standing or walking. Numbness can cause your leg to buckle.
Frequently Asked Questions
There are different kinds of nerve blocks. Your anesthesia team and surgeon will choose the best option based on the type of surgery you are having.
- Single-shot blocks: Generally last about 12–24 hours.
- Continuous catheters: Can provide pain relief for up to 72 hours via a slow medication infusion through an elastic pump.
- Note: Numbness and weakness will slowly wear off over time.
The area may feel heavy, weak, tingly, or “asleep.” For example, an arm block may make your arm feel floppy, or a leg block may make your leg feel weak. This is normal and temporary.
We will use opioids (morphine-like drugs) and other medications to control your pain. These medications will still be available to you for “breakthrough pain” even if you have a nerve block.
Yes. We will advise a nerve block if we think it provides the best pain management. In rare situations where general anesthesia is riskier, we may strongly advise a block for your safety.
Nerve blocks are very safe. Common side effects include soreness or bruising at the site. Less common is a block that does not fully work or numbness that lasts longer than expected. Rare risks include infection, bleeding, allergic reaction, or nerve injury. We use ultrasound and close monitoring to lower these risks.