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tonibunny
21st June 2006, 08:00 PM
Since Titch has already had an epidural steroidal injection and will also be having a facet joint injection, and I have had trigger point injections and will also be having an intercostal block, I thought that it would be a good idea to collect information about these procedures and post them here. All of them come under the umbrella term of "Nerve Block Injections".

The following info is condensed from this webpage (http://www.clevelandclinic.org/health/health-info/docs/0300/0325.asp?index=4417&src=news). Please read the original article for more in-depth info. I've added notes in italics to make it a bit easier to understand for people who aren't well-up on medical jargon :D


What is a nerve block?
Nerve block is a general term, but it basically means the injection of a local anesthetic or a neurolytic agent into or near a peripheral nerve, a sympathetic nerve plexus, or a local pain-sensitive trigger point.

(This basically means that painkilling drugs are injected in or near to the nerves that are causing the pain.)


What are types of nerve blocks? Trigger point injection - injection (shot) of small amounts of local anesthetic and steroid in the area of the muscle where you have pain or tenderness.
Epidural steroid injection - injection of a small amount of steroid medication near nerves in your lower back.
Facet joint injection - injection of a small amount of local anesthetic near facet joints (located on the side or your spine, away from the spinal cord).
Stellate ganglion block - injection of local anesthetic around a group of nerves (found in the neck area).
Lumbar sympathetic block - an injection of local anesthetic around a group of nerves in your lower back (lumbar area).
Intercostal nerve block - an injection of local anesthetic in the area between the ribs.


How long does the pain relief last after a nerve block is given?
Nerve blocks may relieve pain from several hours to several months.


How effective are nerve blocks?
It is important to remember that no single treatment technique is guaranteed to produce complete pain relief. Nerve blocks are very effective in providing temporary pain control, but they are only part of a total pain management program. For patients with chronic pain conditions, a multifaceted approach (treatment that includes rehabilitation and psychological intervention) is essential. A top priority of the pain management program is restoring function of the affected area.


What are the side effects?
Some people have allergic reactions to local anesthetics, but such reactions are rare. People who have allergic reactions to local anesthetics should not receive injections.

Steroids are frequently used in nerve blocks and can cause fluid retention, increased appetite, blood pressure and blood sugar fluctuations, and mood swings.

The use of morphine or morphine derivatives can cause constipation, urinary retention, pruritis (itching), nausea, and vomiting.


When should a nerve block not be performed?
A nerve block should not be performed for patients who are on anticoagulant therapy with heparin or coumadin. These medications can increase the risk of bleeding. In addition, nerve blocks should not be performed for patients who have an active infection around the area of pain or for patients who are allergic to local anesthetics or steroids.


If you have any questions about nerve blocks, post here and I will do my best to find answers for you.


Toni xx

Jonny
22nd June 2006, 01:04 AM
To add a couple of significant things to that:

Usually nerve block injections are guided by either fluoroscopy (x-ray video) or a spiral CT scan.

There's a small risk of lung puncture with intercostal nerve block injections, especially on the ribs under the shoulder blades, because of difficulty of access.