| Frequently Asked Questions |
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| Category #12 - Nerve Injury |
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| Question: |
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Do you see neuropathic pain after blocks?
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| Answer: |
Neuropathic pain does not play a real role in our practice. In fact, we have had some success treating chronic neuropathic pain with continuous peripheral nerve blocks. Having said that, it is important to shy away from interscalene blocks in cases where brachial plexitis may be suspected. We are very careful with patients scheduled for frozen shoulder surgery and for subacromial decompression. We are also much more inclined to do cervical paravertebral blocks than interscalene blocks. We are yet to see a case of post-block neuropathic pain following cervical paravertebral block with a collective experience of about 3,000 blocks. Traction by the surgeons is the most common cause of postoperative neuropathic pain.
One very dangerous maneuver by the surgeon is t apply and inflate a thigh tourniquet in the flexed leg and then straiten the knee. This fixes the nerve to the femur and then applies severe traction to the nerve.
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| Question: |
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Do you perform blocks in patients with a brachial plexitis?
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Brachial plexitis manifests as pain distal to the elbow. We avoid blocks in these patients.
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