Holy Name Press Releases

Holy Name Hospital Offers Cutting Edge Ultrasound Guided Peripheral Nerve Block

January 12, 2010

Ultrasound guided peripheral nerve blocks (PNB) for post operative pain control is a cutting-edge pain relief procedure that allows anesthesiologists to visualize the exact area to be blocked from pain. The goal is to lessen the pain after surgery and to enable patients to get home more quickly allowing for an easier recovery.

Under the direction of Alan Gwertzman, M.D., chief of anesthesia services at Holy Name Hospital, the medical center is currently one of only a few facilities in Northern New Jersey to perform this procedure.

PNB is used most commonly for orthopedic procedures involving the upper and lower extremities and may be used in conjunction with all joint replacement surgeries. This extremely safe and effective pain management option replaces past methods of using electrical stimulation and parasthesias to locate and block the nerve to lessen pain.

"The beauty of this new technology," says Dr. Gwertzman "is this is the first time anesthesiologists can actually see the needle approaching the nerve and confirm the injection was accurate and effective." The ultrasound guidance offers a direct visualization of the nerves and surrounding area.

Dr. Gwertzman explains that in most cases ultrasound guided peripheral nerve block is performed while the patient is awake or slightly sedated, however, in pediatric cases, the patient is commonly under general anesthesia. The type of surgery will determine if the block is performed before or after the operation. "Since the block lasts 12-24 hours," explains Dr. Gwertzman, "we try to maximize the post-operatively pain relief." If the block is performed before surgery patients usually require less overall anesthesia.

It is important for patients to understand that they will have a decreased sensation to heat and cold during the 12-24 hours post-block period and may also experience a tingling sensation, which is expected.

There are different types of PNB depending on the situation and procedure. The anesthesiologist will perform the sterile block in a designated area prior to surgery or in the operating room, while the patient is monitored and lightly sedated. In addition, a local injection may be used to anesthetize the skin before placing the needle. Using a special ultrasound needle, probe and possibly an electrical stimulator, the anesthesiologist locates the nerve to be anesthetized. The anesthetic is injected and the physician observes the spread of the local around the nerve on the ultrasound screen.

"Ultrasound guided PNB is a dramatic departure from the past," notes Dr. Gwertzman. "With the ultrasound allowing us to visualize the needle and the nerve bundles it makes this a very safe and reliable procedure." The use of ultrasound in conjunction with PNB has significantly increased the success rate of patients pain relief.

For additional information on ultrasound guided peripheral nerve block please call 201-833-7149.