Nerve Block - Methods

Methods

Temporary nerve blocks are achieved by combining a local anesthetic (such as lidocaine) with epinephrine, a steroid (corticosteroid), and/or opioids. Epinephrine produces constriction of the blood vessels which delays the diffusion of the anesthetic. Steroids can help to reduce inflammation. Opioids are painkillers. Injection nerve blocks can be either single treatments, multiple injections over a period of time, or continuous infusions. A continuous peripheral nerve block can be introduced into a limb undergoing surgery, for example, a femoral nerve block to prevent pain in knee replacement.

Permanent nerve block can be effected using other drugs or methods including alcohol or phenol to selectively destroy nerve tissue, cryoanalgesia to freeze nerves, and Radiofrequency ablation to destroy nerve tissue using heat.

Nerve blocks are sterile procedures that are usually performed in an outpatient facility or hospital. The procedure can be performed with the help of ultrasound, fluoroscopy (a live X-ray) or CT. Use of any one of these imaging modalities enables the physician to view the placement of the needle. A probe positioning system can be used to hold the ultrasound transducer steady.

In addition, electrical stimulation can provide feedback on the proximity of the needle to the target nerve.

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