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Ultrasound-Guided Nerve Blocks

In keeping with the latest innovations in the healthcare industry, Berkshire Health Systems began using ultrasound guidance to assist with the placement of peripheral nerve blocks in 2007. The advantages of using ultrasound are greater accuracy, increased safety, decreased need for narcotic pain medications post-operatively, and as a result, faster recovery times. Many patients who might otherwise be admitted to the hospital for the purpose of pain control are now able to be discharged on the same day of their surgery.

Some of the procedures for which an ultrasound-guided block may be performed include total joint replacement, shoulder surgery, anterior cruciate ligament (ACL) reconstruction, arteriovenous (AV) fistula creation, and fracture repairs of the upper and lower extremities. Depending on the type of medicine administered, you may expect the affected body part to be numb for several hours after the surgery, or even longer if a catheter is placed.

As a patient, your options will be discussed with you by your anesthesia provider prior to your surgery, and if you are a candidate for a nerve block, it most likely will be performed in the pre-surgical area immediately prior to going into the operating room. An intravenous (IV) line will be placed, as well as appropriate monitors (blood pressure cuff, EKG, and pulse oximetry) and supplemental oxygen. You will be given some form of sedation through your IV, and an ultrasound probe will be used to visualize the nerve to be blocked as well as adjacent structures. Since the ultrasound provides a "real-time" image of the nerves to be blocked, the result is a more accurate and effective nerve block with increased safety.

For some procedures, such as joint replacement, a small catheter may be placed at the time of the nerve block, which may remain in place for several days after your procedure. This catheter will be used to deliver a local anesthetic at a controlled rate for as long as the catheter remains in place (usually less than five days). If you are discharged from the hospital with a catheter in place, full instructions for the care of the catheter will be given to you upon discharge.

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