Common Patient Questions about Nerve Blocks

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 and sometimes longer when necessary A nerve block is not for everyone and your anesthesiologist will evaluate whether it is the right option for you.

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 will 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.

Like general anesthesia, nerve blocks involve some side effects and risks. Most common side effects include unpleasant numbness and weakness of the muscle, when catheters are placed a little bit of leak can occur around the catheter entry and that is totally normal. It is also normal to experience some pain after surgery despite the block. As the block wears off, pain usually increases and it is important to take oral medications early to help control it. Serious complications are very rare (<0.1%) and include large bruise or infection at the block area and persistent nerve symptoms and those are usually temporary.

The placement of a nerve block is associate with minor discomfort. Most patients report that it is less painful than the placement of a small IV catheter. We give all patients sedating medicine to help you relax and then numb the skin prior of the nerve block placement.

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. Most patient prefer to be asleep during surgery then heavy sedation or general anesthesia will be used.

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.

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”.

Usually a nerve block procedure takes 5-20 minutes but the part with the needle last about 1 minute. It takes another 15-45 minutes to start working fully depending on the area numb, the medication used and your personal response to the medication. 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.

We will use IV and oral medications to control your pain during and after surgery.  These drugs may have side effects and may or may not be as effective as a nerve block.  IV and oral Pain medications will be available to you to add to the nerve block and to use as needed. 

Yes. We will tell you about your options and you will decide what is best for yourself. 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. Often we combine the nerve block with general anesthesia to decreases side effects and improve the recovery of general anesthesia.