Indications for nerve block

Epidural anesthesia is very popular, but not everyone knows that epidural is one of the nerve block methods. So in what cases is nerve block done, is nerve block safe?

Nerve blockade is a pain management method that causes loss of sensation in order to prevent or control pain. Nerve blockade can be surgical or nonsurgical.
Nerve block without surgical intervention is a method of injecting drugs around the target nerve or nerve bundle. Medications are used to block nerve impulses from reaching the central nervous system (CNS) and causing pain. Instead, the part of the body that is nerve-blocked will feel numb, and the patient may also experience a stinging sensation.
Nerve block with surgical intervention is a method of cutting or destroying specific nerves very carefully to prevent them from transmitting nerve impulses to the central nervous system. Nerve blockade is effective for 12-36 hours depending on the method of application. Nerve block with surgical intervention can be permanent.
Nerve blockade can be used alone for pain relief or in combination with other pain relief methods.

Nerve blockade is often indicated for the purpose of preventing or controlling pain. Nerve blockade works better than intravenous (IV) analgesia. Doctors usually prescribe nerve block in the following situations:
Pain during labor and delivery Pain before, during and after surgery, such as knee replacement surgery or joint surgery Cancer pain Pain from inflammation joints Lower back pain or sciatica Migraine Regional pain syndrome (CRPS) Shoulder and neck pain due to disc herniation Phantom limb pain Postherpetic neuralgia Pain caused by blood vessel spasm Hyperhidrosis Syndrome Raynaud's Nerve blockade is also used as a diagnostic method to examine the source of pain. By monitoring how nerve blockade affects pain, doctors can determine the cause of the pain and how to treat it.

No special preparation is required for nerve blockade. Patients can still eat and drink normally, should not take anti-inflammatory drugs such as Ibuprofen or naproxen within 24 hours after the nerve block. If you are taking anticoagulants such as Aspirin (Bufferin), heparin, or warfarin (Coumadin), tell your doctor before planning a nerve block.
If the patient is about to have nerve blockade for surgery, the doctor will have some specific preoperative instructions, especially when a lot of pain relief measures will be taken. These guidelines include fasting for 6-12 hours before surgery.

In general, the nerve block procedure includes the following steps:
Cleaning the skin around the injection site Anesthesia at the injection site After the anesthetic takes effect, the doctor inserts the needle into the site under the guidance of the ultrasound sound, fluoroscopy, computed tomography, or simulation to guide the needle and deliver the drug in the correct position. Once in place, the doctor will inject numbing medicine. The patient will be taken to the recovery room and monitored for adverse drug reactions. In the case of a diagnostic nerve block, the doctor will ask to check the analgesic effect.

Pain that originates from different parts of the body requires different nerve blocks, eg:
5.1 Upper extremity nerve block (brachial plexus) Alternating nerve block (shoulder, clavicle or upper arm) supraclavicular nerve block (upper arm) hypoclavicular nerve block (elbow down) 5.2 facial nerve block trigeminal nerve block (face) Ocular nerve block (eyelids and scalp) Supraorbital nerve block (forehead) Maxillary nerve block (maxillary) Sphenopalatine nerve block (nose and palate) 5.3 Cervical and dorsal nerve blockade Cervical (neck) epidural block thoracic spine epidural block (upper back and ribs) Lumbar spinal epidural block (lower back and buttocks) 5.4 Thoracic and abdominal nerve block Paravertebral nerve block (thoracic and abdominal) Intercostal nerve block (thoracic/costal) Transverse abdominal muscle anterior block (lower abdomen) 5.5 Lower extremity nerve block Block hypogastric (pelvic) plexus Lumbar plexus (front part of leg, including thigh, knee, and sub-knee saphenous vessels) femoral nerve block (entire anterior thigh, most of the femur and knee, and part of the hip, but not the back of the knee) Sciatica (back of the leg, lower leg, ankle, and foot) block, including nerve block popliteal nerve block (below the knee) Nerve block is also classified by injection method or with or without surgical intervention:
5.6 Nerve block without surgical intervention Epidural: Drug is injected space outside the spinal cord to numb the abdomen and lower extremities. Epidural anesthesia is perhaps the most commonly recognized type of nerve block and is commonly used during childbirth. Spinal anesthesia: Numbing medicine is injected into the fluid that surrounds the spinal cord. Peripheral: The drug is injected around the target nerve causing pain.

5.7 Surgical Nerve Blockade Sympathetic Nerve Blockade: Helps prevent pain from the sympathetic nervous system in a specific area. This method can be used to treat excessive sweating in specific parts of the body. Neurectomy: A damaged peripheral nerve is surgically removed, used only in rare cases of chronic pain, when no other treatments are successful. such as chronic regional pain syndrome Spinal nerve root ablation: The roots of nerves extending from the spine are surgically treated. This method can be used for neuromuscular conditions such as hemiplegia or spastic cerebral palsy. 5.8 How long does a nerve block last? Nerve blockade usually lasts from 8 to 36 hours depending on the method. Sensation and movement in that part of the body will gradually return. In some cases, the doctor may use a nerve catheter to continuously infuse anesthetic into the nerve for two to three days after surgery. This is when a small tube placed under the skin near the nerve is connected to an infusion pump and the anesthetic is injected continuously for a set amount of time.

Most surgical methods of nerve blockade can be considered permanent. But they are usually reserved for rare cases of chronic pain or when no other treatments have been successful. Such as cancer pain or chronic regional pain syndrome.
For permanent nerve block, the nerve itself is completely destroyed by targeted nerve severing, removal or injury with small electrical currents, alcohol, phenol, or cryogenic freezing.
However, not all procedures that permanently destroy nerves are actually permanent. They may last only a few months, as the nerve may regrow or repair itself. When the nerve grows back, the pain may return, but it may not.

Nerve blockade is very safe, but as with any other medical procedure, nerve blockade always carries risks. In general, nerve blockade has fewer side effects than most other pain relievers. Side effects and risks of nerve block include:
Infection Bruising Bleeding Pain at the injection site Intravenous nerve blockade Horner's syndrome, which causes eyelid drooping and decreased pupil size when the median nerve occurs brain and eyes affected (usually goes away on their own) Nerve damage (rarely and usually temporary) Overdose (rarely) Nerve blockade may result in numbness or weakness lasting up to 24 hours. During this period of anesthesia, the patient will not be able to feel pain, so be careful not to place objects that are too hot or too cold on this area, or bump, trauma or interfere with the week. complete to the sealed part. Tell your doctor right away if numbness or weakness does not go away after 24 hours.
Nerve blockade is an effective pain reliever treatment that is widely used in medical treatment, but not all patients can use this procedure. The choice of method should be prescribed by a specialist.
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Reference source: healthline.com