Interscalene Nerve Block

 

What is an Interscalene Nerve Block?

  • An interscalene nerve block is performed to treat chronic pain of the upper extremity.
  • It involves the injection of local anaesthetic and steroid into the brachial plexus - a group of nerves at the side of the neck. 
  • The steroid reduces inflammation, irritation and swelling around the brachial plexus.
  • A nerve stimulator is used to assist with needle placement during the procedure. Radiological imaging may be used in some cases.
  • The block may be performed once or as a series of injections. 

 

Prior to the Procedure

  • All blood thinning products (except aspirin) must be stopped prior to your procedure. You will be advised by letter when to stop taking these medications at the time that your admission date is arranged.
  • You are able to take your other regular medications with a sip of water on the morning of your procedure.
  • If you are an insulin dependent diabetic you will always be at the beginning of the list. Please bring your insulin with you and it will be given to you following your procedure.
  • Hamilton Day Surgery Centre staff will advise you of your fasting and admission times.
  • You must not have anything to eat, drink, smoke or chew prior to your procedure.
  • You will need to organise someone to drive you home after the procedure as you will not be able to drive for 24 hours after your procedure.

 

What Will Happen?

  1. You will be admitted to the day surgery by a nurse and you will be asked to change into a gown.
  2. The anaesthetist will speak with you and place a cannula (plastic needle) into a vein in your hand.
  3. In the procedure room, you will be assisted to position on the procedure table, lying on your back with a small foam support for your head. 
  4. The anaesthetist will give you some sedation into your vein. 
  5. You will be positioned with your arms by your side and your head turned away from your affected side.
  6. Steroid and local anaesthetic will be injected once correct placement has been established with use of a nerve stimulator and sometimes X-ray guidance.
    • The procedure will take approximately 5 minutes to complete.
  7. After the procedure, you will be placed on a trolley and taken to recovery, where you will remain for approximately 1 hour.
  8. After having something to eat and drink, you will be discharged with a carer.

 

Post Procedure

  • Gentle activity and rest is recommended in the first 24 hours following the procedure. You may then return to normal activity.
  • Your affected arm may be heavy and need supporting until the local anaesthetic block wears off.
    • The day surgery will send you home with a sling for your arm if necessary. It is essential that you support your arm until the heaviness fades; Don't "let it hang".
  • The local anaesthetic will wear off 12-18 hours following your procedure.
  • The steroid will take approximately 48 hours to start working.
    • During this time, there may be a window of increased discomfort or pain.
  • A nurse from HPC will telephone you 24 to 48 hours following your procedure to check on your progress and organise a follow up appointment. 
  • The steroid may last from 1 - 6 months, depending on the amount of irritation or inflammation present.


If you require further explanation of the procedure, please contact Hunter Pain Clinic nursing staff on (02) 4985 1800.

 

* Image adapted from David Shankbone (Foto), Grey's anatomy. [GFDL (http://www.gnu.org/copyleft/fdl.html) or CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons