Brachial Plexus Block

What is a brachial plexus block?

A brachial plexus block is a medical procedure that involves the administration of a dose of local anesthetic into an area either in your neck, above your collarbone or into your upper arm (near the armpit). This block may be performed as a single injection or a very small catheter may be inserted into one of these areas in order to provide continuous or repeated administration of medication. This treatment has brought relief to many patients who suffer from chronic pain of their arm and shoulder.

How quickly can I expect pain relief?

Relief is fairly quick (within 10 to 15 minutes) after the injection of medication.

How should I prepare for the procedure?

The brachial plexus block is a safe medical procedure but, as with any procedure, it has risks as well as benefits. To minimize the chance of complications, we ask that you follow a few simple guidelines:
Do not eat or drink anything for 6 hours prior to the procedure.
It is required that you be accompanied to and from the Advanced Pain Institute by a responsible adult driver. Most likely you will be offered a small dose of intravenous medication during the procedure which will act to not only decrease anxiety, but provide you some relief from the minor discomfort of the procedure itself. This intravenous medication that you receive will impair your driving ability; therefore, it is imperative that you be accompanied by a responsible adult driver.

What happens during the procedure?

First, an intravenous line will be placed, generally in your hand. We will then bring you to the operating room and place several monitors on you, such as a heart, blood pressure and a pulse monitor. These will enable us to monitor your vital signs throughout the procedure. Following placement of the monitors we will begin to give you some intravenous medication in order to decrease anxiety, as well as provide you with some pain relief.
After cleaning a small patch of your skin in the region of your neck, your collar bone or your upper arm, the local anesthetic is injected into the skin to decrease any pain associated with the performance of this procedure. After exact placement of the needle is confirmed, your physician will administer the medication through a small needle. If you and your physician had decided pre-operatively to place a catheter for more continuous administration of medication after the procedure, this will then be placed in the proper position. The procedure itself usually lasts 20 minutes. Occasionally, patients describe a recurrence of their normal arm or shoulder pain during the administration of the medication. This is viewed as a reassuring sign that the medication is going to the right place and the sensation should disappear very quickly.

What happens afterwards?

After the brachial plexus block is performed, we will continue to monitor you in the recovery room for 30 to 40 minutes. If there are no signs of any problems, you will be discharged. If you have any questions after your procedure, the medical staff of the Advanced Pain Institute is on call 24 hours a day, 7 days a week. You can reach either the nurse or physician by calling (626) 445-2371.

Will my insurance cover the procedure?

The brachial plexus block is a well established medical procedure and is reimbursed by most insurance companies. Any need for preauthorization of services or copayments depends on your insurance carrier. Our office staff will assist you in obtaining preauthorization whenever possible.

What should I expect from this procedure?

A dose of local anesthetic will be administered through a small needle into an area either located in your neck, above your collar bone, or in the upper part of your arm. Your physician then may place a small catheter into one of these locations. This would have been discussed with you prior to the procedure and would enable administering a more continuous delivery of medicine. In some instances, despite the medicine being administered to the appropriate location, the patient is not experiencing any pain relief. Although this is unfortunate, it may give your doctor some valuable information.

What possible side effects might I see?

Occasionally patients will describe recurrence of their normal arm or shoulder pain during administration of the medication. This is viewed as a reassuring sign that the medication is going to the right place and the sensation usually disappears very quickly. Other possible risks of this procedure include bleeding, infection, or the injection of medication into a blood vessel which potentially can cause seizures. These risks are extremely rare, and your physicians will be continually monitoring your vital signs in order to guard against these complications.

What should I do if any problems develop after I leave the hospital?

If you have any questions after the procedure, the medical staff of the Advanced Pain Institute is on call 24 hours a day, 7 days a week. You can reach either the nurse or physician by calling (626) 445-2371.

Post procedural instructions

These will be provided for you, in further detail, by the recovery room nurse prior to your discharge from the Advanced Pain Institute. These instructions should include: no driving or operating heavy machinery for 24 hours after the procedure. This is recommended secondary to the fact that you have received intravenous medication during a procedure which may impair your ability to perform these tasks.
In addition, some patients notice weakness in the arm or shoulder that has been “blocked.” It is important, therefore, for you not to attempt to lift heavy objects with this arm for 12 to 24 hours after the procedure.