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One area of pain relief that has become popular is regional anesthesia. This type of anesthesia provides relief by placing local anesthetics (numbing medicines) near nerves, temporarily stopping them from carrying pain and other sensory signals to the brain. This type of injection is often done in the dentist’s office, in the delivery suite for labor pain and in many other medical settings. There are special considerations for conducting these injections in children, and a select group of our anesthesiologists are experts at making these injections safe and effective.
Before surgery, our team members may talk with you about whether a nerve block or nerve block catheter is right for your child. Be sure to tell the doctor if your child has any history of nerve problems: weakness, numbness or tingling. If your child has a problem with easy bruising or bleeding, or infections in the area of surgery, let us know. The anesthesiologist on the regional anesthesia team will tell you the details of the procedure, what to expect, how long the block will last, and help establish a plan for how to treat the pain when the numbness wears off.
Nerve blocks are often done under general anesthesia, especially in younger children. Since the nerves lie deep under the skin, a needle is used to get the medication where it needs to go. We use either ultrasound guidance or a special nerve stimulator to help us find the appropriate nerves. If the most appropriate nerve block is a one-time injection of medicine, the injection may be done at the end of surgery, so the numbness lasts for the longest amount of time. If a surgery involves a catheter (a thin length of tubing that can carry medicine), then a special needle will be used that allows us to insert the catheter next to the nerve. The catheter is carefully secured to the skin, and can remain in place for up to three days, with a pump injecting small amounts of medicine near the nerve the whole time.
The numbness of a single injection can last up to a day after surgery. While the body part is numb, extra care will be needed to make sure nothing happens to the area since it will not have the protection that comes with full sensation and strength. At some point, the pain will return, and additional pain medications will be needed to keep it under control. If a catheter is used, the pain will mostly be controlled for two to three days with continuous instillation of numbing medication. Though there will be less pain than with a single injection, there will be some pain. We will give you an information sheet about the block, with tips on how to best care for the area of the operation while it is numb, how to care for the pain when the block wears off, and warning signs to watch for. A member of our nursing staff will call you to check on your child and answer any questions you have. Any concerns about the block will be relayed to one of our of our regional anesthesia doctors, who will follow up with you if needed.
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