Brachial-Plexus Nerve Block

The brachial plexus is a nerve-fiber network that runs from the spine, through the neck and armpit region, into the arm. A brachial-plexus injury affects the nerves that send signals from the spine to the arms, shoulders and hands. It occurs when nerves are stretched, compressed or torn, often during contact sports. Minor brachial-plexus injuries can heal on their own, but more severe injuries can require surgery. A brachial-plexus nerve block provides pain relief via an injection of local anesthetic.

Candidates for a Brachial-Plexus Nerve Block

Although contact sports often cause brachial-plexus injuries, they also result from the following:

  • Tumors
  • Falls
  • Congenital defects
  • Stab or gunshot wounds
  • Car accidents

A patient with a mild brachial-plexus injury may experience weakness and numbness, or a burning sensation, in the arm; a patient with a severe brachial-plexus injury may experience loss of shoulder and elbow control, an inability to use the fingers, and inability to move or feel the arm.

The Brachial-Plexus Nerve Block Procedure

A brachial-plexus nerve block can be performed with a local anesthetic, although sedation or full anesthesia is an option if the patient desires. The procedure takes about 15 minutes, with a 30-minute recovery period. The injection site may be anywhere along the path of the brachial plexus; common injection sites include the base of the neck, the armpit, and the front of the shoulder.

A local anesthetic is applied to the injection site, and the surrounding skin is cleaned. With the assistance of X-rays and contrast dye, a needle is inserted. Once the needle is situated properly, the medicine is injected. The patient's pain should be reduced almost immediately, but the length of time it lasts varies.

Risks of a Brachial-Plexus Nerve Block

Possible risks from a brachial-plexus nerve block are similar to those for most nerve-block procedures, and include the following:

  • Soreness at the injection site
  • Elevated blood sugar
  • Bleeding

Rare but serious complications include temporary or permanent nerve damage, convulsions and cardiac arrest.

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