Nerve Blocks

Nerve blocks are a way to help reduce pain and discomfort after surgery. Nerve blocks are performed by injecting numbing medication around the nerves that carry painful sensation from an arm or leg.

In almost all pediatric patients nerve blocks are used together with general anesthesia for surgical procedures.

Depending on the age of the patient, nerve blocks can be performed while the patient is still awake, or more commonly, after the patient is asleep under general anesthesia.

The exact place where numbing medication is injected depends on where the surgical procedure is performed.

For procedures on the shoulder, arm, elbow or hand, injections may be made at the side of the neck, below or above the collar bone, or in the armpit.

For procedures on the leg, knee or foot, injections may be made in the groin, the buttocks, the thigh, or the back or side of the leg.

The anesthesiologist will discuss with you which nerve block will work best for your child and its benefits and risks.

Nerve blocks can provide significant pain relief after surgery. They often substantially reduce the need for pain medications as well as pain medication-related adverse effects, such as vomiting, drowsiness and slow breathing. A nerve block may help your child to get up in a chair or walk around after surgery without being very uncomfortable.

One time injection (single shot) nerve blocks typically provide pain relief for eight to 24 hours.

Continuous nerve blocks with nerve catheters for major painful surgeries can provide pain relief for typically two to three days or as long as the nerve catheter is being used.

In general, complications are extremely rare with the sort of nerve blocks used at Cincinnati Children's. However, possible complications include:

  • Less than perfect pain relief
  • Bruises
  • Discomfort where the needle was inserted
  • Prolonged "pins-and-needles" sensation after the block wears off

Any type of long-lasting or permanent damage to nerves is extremely rare.

Your anesthesiologist will discuss any potential problems and risks with you in detail.

The arm or leg where the nerve block has been performed will be so numb that no or only little pain will be felt. Therefore, it is important to watch that nothing harms it while it is still numb because no pain would be felt. Keep it away from heaters, fires, car doors and sharp objects.

When the numbness wears off, the pain or discomfort will increase. The amount of pain will vary depending on the operation.

The best way to keep your child comfortable is for him / her to take the medication that has been prescribed as soon as the pain begins. It is better to treat pain in advance than to catch up with it.

For certain operations, taking ibuprofen as soon as possible – even before the nerve block wears off – can decrease pain. This should be discussed with your child's doctor at the time of surgery.

It is possible that some nerve blocks may last longer than a day.

However, if your child is not able to move the arm / leg or feel any sensation at all (touch, warm, cold, pain) for more than 24 hours after a nerve block was placed, contact us at 513-636-7768.

For major and painful surgeries such as knee reconstruction or shoulder surgeries, a continuous nerve catheter (thin plastic tube) placement is often needed to provide extended pain relief for typically two to three days.

Nerve catheters are placed by anesthesiologists in the operating room while children are under anesthesia and continuous infusion of numbing medication.

Sometimes, children are discharged home with nerve catheters and a numbing medication infusion pump to provide pain control at home for two to three days. For families living within 50 miles of the hospital in Ohio and Kentucky, daily home care nurse visits could be arranged to check on pain relief, nerve catheters and infusion pumps and for removal of nerve catheters.

The Acute Pain Service will actively manage children with nerve catheters.

If you have questions or concerns about your child's nerve block, you may call the pain clinic at 513-636-7768 during clinic hours.


Last Updated 11/2013