NERVE BLOCK

LOCAL ANAESTHETIC NERVE BLOCK 

Local anaesthetic nerve blocks are medical procedures used to interrupt pain signals by injecting local anaesthetics around specific nerves. This technique is widely employed in various medical fields, including surgery, pain management, and dentistry, to provide localized pain relief without affecting the entire body.

Types of Local Anaesthetic Nerve Blocks

Local anaesthetic nerve blocks can be categorized into several types depending on the area of application:

Peripheral Nerve Blocks: 

Target specific nerves to provide pain relief in localized areas, such as the arms or legs.

Neuraxial Blocks: 

Include spinal and epidural anesthesia, which affect larger areas by targeting the spinal cord.

Intravenous Regional Anesthesia (Bier Block): Involves injecting local anesthetics into the veins of a limb after isolating it with a tourniquet, typically used for short procedures.

Indications for Use

Surgical Procedures: 

To provide anesthesia for operations on specific body parts without general anesthesia.

Postoperative Pain Management: 

To reduce pain after surgery, particularly in orthopedic and thoracic procedures.

Chronic Pain Management: 

To alleviate pain from conditions like neuropathic pain, where nerves send incorrect pain signals to the brain.

Procedure Overview

Preparation: 

The patient is informed about the procedure, and consent is obtained. In some cases, sedation or general anesthesia may be used, especially in pediatric patients.

Injection: 

A local anaesthetic (sometimes combined with corticosteroids) is injected near the targeted nerve. This can be done using ultrasound guidance for better accuracy.

Monitoring: 

Patients are monitored for immediate reactions and potential complications, such as local anaesthetic systemic toxicity (LAST) or nerve injury.

Contraindications

Allergy to local anesthetics.

Patient refusal.

Relative Contraindications:

Active infections at the injection site.

Coagulopathies or bleeding disorders.

Preexisting neurological deficits.

Inability to cooperate during the procedure.

Complications

Nerve Injury: 

Rare but can occur if the needle damages the nerve.

Infection: 

Risk of infection at the injection site if sterile techniques are not followed.

Local Anaesthetic Systemic Toxicity (LAST): Symptoms can include tinnitus, seizures, and cardiovascular issues, particularly if the anaesthetic enters the bloodstream.

Hematoma Formation: 

Particularly in patients with bleeding disorders or those on anticoagulants.

Conclusion

Local anaesthetic nerve blocks are effective methods for managing pain in various clinical settings. The choice to use this technique depends on the specific medical scenario, patient characteristics, and the experience of the healthcare provider. Proper technique and awareness of contraindications and potential complications are essential to ensure patient safety and optimal outcomes.

Local anaesthetic nerve block