Interscalene Block

Interscalene (Brachial) Nerve Block

An interscalene block is an injection of a local anesthetic (like Novocain) around a group of nerves, called the brachial plexus, that go to (innervate) the muscles and skin in your arm and hand. This block is performed for the diagnosis and treatment of neuropathic (nerve) pain involving your arm and/or hand. Neuropathic pain sometimes occurs after an injury, especially when a nerve has been damaged. Temporarily blocking or disrupting painful nerve impulses associated with neuropathic pain can result in various degrees of permanent relief. If, after following a single block, you achieve partial permanent relief, a series of these blocks can be performed of which each successive block may give a greater degree of sustained relief. The nerves are blocked in the neck area, between the scalene muscles of the neck. This is why the block is called an interscalene block.

The block will take 15 to 30 minutes to be performed. You will first have an IV placed in your arm before the procedure. You will be placed in the supine position (face up). Your head will be turned slightly to the opposite side of your pain, with your arms at your sides. Your neck will be cleansed with an antiseptic solution. The doctor will place the needle and you may feel a sharp or tingling sensation when the needle locates the nerve. At times, a nerve stimulator might be used to locate the nerves. In that case, you will some involuntary contraction in your arm and hand muscles. The local anesthetic is then injected. After the needle is removed, pressure will be applied to the area for a few minutes. A Band-Aid may be applied to the injection site. You will rest, lying down for 15 minutes after the procedure. A nurse will monitor your blood pressure and pulse. You may have decreased sensation and strength in your arm for up to 24 hours. A sling may have to be applied to your arm if weakness occurs. The nurse will review your discharge instructions with you before you go home.