Nerve Block

Anesthesia will typically provide a nerve block prior to surgery. It is your choice as to if you would like to receive the nerve block, but it is generally recommended to help with pain control. This decision is made the day of surgery after the anesthesia team explains the risks and benefits.

What is an interscalene block?

An Interscalene Block (ISB) numbs the shoulder for surgery. An anesthesiologist will do this procedure before surgery. It may provide anesthesia for the surgery itself, or be given with general anesthesia to provide pain control when you wake up. Either way, the goal is for you to have less pain and require less medication with fewer side effects.

How is an ISB performed?

With you lying on your back or your side, your provider will perform an ultrasound of the neck to find the nerves which supply your shoulder, arm, and hand. A local anesthetic (numbing medicine) will be injected in this area. For some surgeries, a small catheter will then be placed and taped to your neck. (This is called a Continuous Interscalene Block, or CISB.) This catheter will deliver a continuous infusion of local anesthetic. The procedure takes about 15 to 30 minutes.

How long will the ISB give me pain relief?

Single injections last about 12 to 24 hours. Consider taking pain medication at bedtime, so that you are likely to have a comfortable night’s sleep as the ISB wears off. For CISBs, catheters usually stay in place and provide relief for 2-3 days. Once the catheter is removed, it may take several hours for the numbness and weakness to wear off. This is completely normal and expected.

Is there anything I shouldn’t do after an ISB?

Your shoulder, arm, and sometimes fingers will be numb and weak after an ISB. Do NOT remove the sling, use the arm, or operate a motorized vehicle until cleared to do so by your surgeon or physical therapist.

Are there any risks or side effects?

ISBs are very safe. Side effects include a hoarse voice, drooping eyelid, small pupil, and/or nasal stuffiness on the side of your ISB. These are temporary and last only as long as the ISB. All procedures are done using sterile technique and ultrasound guidance to reduce the risk of bleeding, infection, and nerve injury. Nerve injury is rare, and can be temporary or permanent, causing numbness, weakness, or burning pain. Talk to your anesthesia provider if you have specific concerns.

What if I have questions after my ISB?

During your hospital stay, you will be seen by an anesthesia provider every day if you have a catheter in place. For urgent concerns after discharge, call 720-848-0000 and ask for the Acute Pain Service on call. If you are discharged with a nerve catheter, please read the handout you are sent home with for instructions.