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nerve block

INTRODUCTION

After assessing your medical history, condition and treatment options, the anesthesiologist/pain specialist has consulted with you and concluded that a nerve block is the most suitable treatment option for you.

A nerve block is a form of pain management and there are various types of nerve blocks. This brochure contains general information about nerve blocks and what you can expect. If you receive a specific nerve block, such as a spinal nerve block or a sacroiliac (SI) joint block, you will receive a separate brochure.

HOW DOES A NERVE BLOCK WORK

A nerve block works by numbing the nerve that conducts the pain signal to the brain. Once this nerve is numbed, it can no longer transmit the pain signal to the brain. Because no pain signal reaches the brain anymore, you experience less pain.

DIAGNOSTIC BLOCK AND THERAPEUTIC BLOCK

For certain pain complaints, the anesthesiologist/pain specialist will first try to determine which nerve is conducting the pain by means of one or more diagnostic (test) blocks. A diagnostic block is the temporary numbing of the nerve.

A definitive or therapeutic nerve block can only be performed after the nerve conducting the pain has been located. A diagnostic block is not always necessary for this. Your treating specialist will discuss with you in advance whether a diagnostic block is necessary. More information about this can be found in the brochure on the relevant nerve block.

A therapeutic nerve block can provide pain relief for a longer period of time. If the complaints return, the block can be repeated if necessary.

It is usually not possible to perform a diagnostic and a therapeutic block on the same day. However, your treating specialist aims to keep the time between the diagnostic and the definitive block as short as possible.

HOW CAN I PREPARE

  • If you use anticoagulants (also called blood thinners) (for example Sintrom®, Marcoumar® or Acenocoumarol, Rivaroxaban or Dabigatran), you must stop taking them before the treatment. Consult your anesthesiologist/pain specialist to find out how long in advance you should stop.
  • Inform the anesthesiologist/pain specialist of any allergies or hypersensitivity to X-ray contrast fluid, or if you are pregnant or may be pregnant.
  • The treatment almost always takes place on an outpatient basis. Please note that after a nerve block you may NOT drive home yourself, because after the block there may be temporarily less strength in the treated arm or leg. You may also feel tired and dizzy after the treatment.
  • With a nerve block you may usually eat and drink as normal. If you need to fast, the specialist will discuss this with you in advance.
  • If you must fast, the following agreements apply regarding eating and drinking:
  • - You may have a light meal up to 6 hours before your hospital appointment (for example 2 slices of bread or 2 biscuits with a low-fat topping).
  • - You may drink clear fluids up to 2 hours before the treatment (tea, coffee without milk, clear apple juice, water), but no milk, dairy products or orange juice.
  • The treatment usually takes 15 to 30 minutes, but there are also treatments that take an hour or longer. More information about the duration of the treatment can be found in the brochure on the relevant block.
  • A diagnostic block cannot proceed as planned if you have no pain on the day of the treatment, because we cannot then properly assess whether the treatment is working.
  • If you have a fever on the day of the treatment, the treatment unfortunately cannot proceed as planned. Contact the outpatient clinic as soon as possible using the contact details on the back of this brochure!

HOW DOES THE PROCEDURE WORK

The treatment room of the pain clinic is located in the operating theatre. The anesthesiologist/pain specialist and an anesthesia nurse are present during the treatment.

For the treatment you lie on your stomach or back, depending on the location where the block is to be performed. During the treatment, X-rays are often taken; the device is placed next to the table on which you are lying.

The block is performed with special needles and the place where the needle is inserted depends on where you experience pain. This is determined very precisely in advance. Before the needle is inserted, the anesthesiologist/pain specialist disinfects the skin and the anesthesia nurse administers a local anesthetic at the spot where the block will be performed.

The anesthesiologist/pain specialist guides the treatment needle to the nerve or nerve ganglion to be treated using X-ray imaging. During the treatment, the anesthesiologist/pain specialist checks with the help of X-rays whether the needle is in the correct place. For a good X-ray image, it is sometimes necessary to inject contrast fluid. The anesthesiologist/pain specialist also sends small electrical pulses through the needle to check whether it is in the correct place.

After the treatment, the needle is removed and a plaster is applied to the injection site.

In a diagnostic block, the anesthesiologist/pain specialist injects a numbing fluid into the nerve, similar to an anesthetic used at a dentist.

In a therapeutic nerve block, a special numbing fluid is injected or the nerve is treated with small electrical currents. This prevents the nerve from transmitting pain signals.

WHAT HAPPENS AFTER THE TREATMENT

After the treatment you are taken to a separate area in the recovery room. There you can recover and wait for the result of the treatment. The plaster applied to the injection site can be removed the next day. You can then shower or bathe normally again. After some blocks, temporary loss of strength or numbness may occur. Therefore, it is important that you come to the hospital accompanied.

WILL I HAVE PAIN AFTER THE TREATMENT

During the treatment, mild pain may occur. This pain may last a few days to weeks. If necessary, you can use paracetamol to relieve the pain.

After a definitive nerve block, the existing pain can sometimes increase before it improves. The effect of the definitive block can only be assessed after some time (six weeks to three months). A follow-up appointment at the outpatient clinic will then be scheduled with you to evaluate the result and the success of the treatment.

Are there side effects or complications

All medical treatments and procedures carry risks, but a diagnostic or definitive nerve block rarely leads to permanent damage. The anesthesiologist/pain specialist will also discuss your medical history with you to make sure there are no other factors that could lead to complications and, if there are, how the procedure can be performed most safely and with minimal risk.

WHAT CAN I EXPECT AFTER THE TREATMENT

The result of a diagnostic nerve block can often be assessed quickly. Before you go home, the anesthesiologist/pain specialist will visit you to discuss the effect of the treatment. After your discharge from the hospital, it is important to keep track of whether the pain has decreased and, if so, how long the pain relief lasted. The anesthesiologist discusses these results with you during the follow-up appointment (after the procedure). Depending on the result of the diagnostic nerve block, he or she will determine, in consultation with you, whether a definitive nerve block may be useful to fully relieve your pain.

PREGNANCY AND NERVE BLOCKS

Because X-rays are used during the procedure, it is important to know whether you are pregnant or may be pregnant, since radiation can be harmful to your unborn child. If you are pregnant or suspect you are pregnant, inform your nurse or anesthesiologist/pain specialist before the procedure.

QUESTIONS

Do you have questions about the information in this brochure? Then contact the anesthesiologist/pain specialist using the contact details on the back of the brochure.