Interscalene/Brachial Plexus Block

An interscalene/brachial plexus block may be used therapeutically for chronic pain conditions of the upper extremity, such as complex regional pain syndrome (CRPS), Raynaud's phenomenon, and peripheral neuropathies.

What is the purpose of the injection?

The purpose of this block is diagnostic and/or to block pain in the affected arm allowing increased mobilization during physical or occupational therapy.

What is injected?

This injection consists of a local anesthetic given via a catheter.  This can be done as a single injection or the catheter can be left in and secured with a dressing for daily injections. The daily bolus allows for pain relief during physical or occupational therapy.

Does the procedure hurt?

The procedure is done with x-ray guidance and involves inserting a needle through skin and deeper tissues. There is some discomfort involved. However, the skin and deeper tissues are numbed with a local anesthetic. Most of the patients also receive intravenous sedation which makes the procedure easy to tolerate.

What are the risks and side effects?

With any procedure there are risks, side effects, and possibility of complications. Risks include infection, bleeding, puncture of a lung, and allergic reaction to medications used. There is a possibility the medicine could inadvertently enter the blood stream causing the following symptoms: ringing in the ears, numbness around the mouth, metallic taste or symptoms affecting the central nervous system.

What should I expect after the injection?

After the injection, your pain will be decreased which is a result of the local anesthetic. You may have numbness or loss of function in the affected arm (to be expected). You may also experience on the affected side, drooping of the eyelid, hoarseness, constricted pupil, difficulty swallowing and nasal stuffiness. Should you experience difficulty swallowing, avoid food or liquid until this resolves, usually within 2 hours.

What should I do to prepare for the procedure?

1. You must have someone with you. You will not be allowed to drive home.
2. You may take routine medications including pain medicine.
3. You must not eat or drink 6 prior to you procedure unless otherwise directed.

What should I expect the day of the procedure?

1. Your medical history will be reviewed.
2. An IV will be started.
3. You will be monitored during and for a minimum of 30 minutes after the procedure.