What is it?
A selective nerve root block (SNRB) is the injection of a local anesthetic along a specific nerve root. This procedure is used primarily to diagnose nerve root compression. SNRB injections are isolated to various locations along the spine to determine which nerve root is causing the pain. If the patient’s pain dissipates after the injection at a particular nerve root, it can be inferred that the source of pain was being generated at the selected nerve root. Along with acting as a diagnostic tool, SNRBs can alleviate the discomfort associated with nerve root compression when used with an injectable steroid.
What Happens during Selective Nerve Blocks?
A selective nerve block is performed by injecting a local anesthetic adjacent to vertebral foramina along the spine from which nerve roots emerge. Prior to the block being administered, the site is anesthetized with a local anesthetic.
Patients may feel some mild radiating pain as the medication is injected adjacent to the affected nerve root.
The procedure itself only takes 15-30 minutes to perform. You will be observed in the recovery room for 20-60 minutes after the procedure.
What happens after the procedure?
Most often you can go home in about 20-60 minutes. It is important to assess your immediate level of pain relief prior to going home. You may be given a pain log to help you document the extent and duration of pain relief you experience that day. Written instructions will be sent home with you. You will need someone to drive you home and care for you for the first few hours after the procedure. It is recommended that you take it easy for the rest of the day. It is advised that patients rest for a few days following the procedure.
Possible Side Effects
There are few side effects of selective nerve blocks. Immediately after the procedure, your arms and legs may feel heavy and numb. This is due to the local anesthetic and usually wears off within a few hours. Other side effects can include pain at the injection site and headaches. In rare cases, patients experience infection, bleeding or nerve damage.
What to expect the day of your procedure?
You are expected to arrive at the surgery center at least one hour before your procedure is scheduled. Bring a responsible adult driver with you because you may be receiving medications that could impair your ability to drive. Unless you are certain you will not be receiving sedation, do not eat anything for 6 hours prior to your procedure; you may have modest amounts of clear liquids (liquids you can see through) up to 4 hours beforehand. Please take your regularly scheduled blood pressure, heart, asthma, long-acting narcotic and nerve pain medications with sips of water as you normally would. If you have diabetes, take half of your normal dosage and bring your insulin with you. Be sure to discontinue aspirin products and any other blood thinners as instructed.
After you arrive, you will be asked to sign-in and complete any paperwork as needed. You will then be taken to the preoperative area. At this time, a nurse will ask you some medical questions and have you sign your consent forms. It is imperative that you, the patient, inform the assistant of any changes in your history and/or physical, such as recent flu or any health problems that might affect your procedure. Inform the staff of any allergies, especially to Betadine or Iodine.
You may be asked to change into a gown. An assistant will take your vital signs and an IV may be started in order to provide pain relief and relaxation.
The physician and nurse will talk to you before your procedure. In certain cases, an anesthesiologist may also be utilized. You will then be positioned and the injection sites will be prepped. Your pain management physician will perform the procedure. Medications may be administered before and during your procedure to help you relax and provide pain relief. You may doze off during this time. Afterward, bandages will be applied as needed.
You will be transported to the recovery room area where you will be monitored anywhere from 30 minutes to an hour. You will be offered beverages and some crackers. After this, someone will take out your IV and help you get dressed if needed. Lastly, your caregiver will be given discharge instructions for your care at home.