The shoulder
Interscalene block
Most procedures on the shoulder and upper arm cause a lot of pain after the operation. For this reason, an interscalene block is often performed.
The interscalene block is performed before you are put to sleep. Placing this interscalene block takes about 15 minutes in total. The block is done in the preparation area, and you may have to wait for a while before the operation starts.
In the neck area, the correct spot where the anaesthetist will insert the needle is located. After disinfection and local numbing of the skin, the nerves that supply the shoulder and arm are identified. This is done with a needle, which you will feel moving under the skin. This is usually not painful. The nerves are located using small electrical impulses that make the arm or shoulder move. This is not painful in itself but can feel unpleasant. After the local anaesthetic has been injected, a small tube is left near the nerves. Through this tube, local anaesthetic can then be given using a pain pump.
As with any technique, this technique can also involve certain complications: infection at the puncture site, nerve injury from the needle, allergy to the disinfectant or local anaesthetic agents, injection of the local anaesthetic into the bloodstream with a toxic reaction, temporary shortness of breath, temporary drooping eyelid, temporary hoarseness, and so on. A member of the anaesthesia team can, if you wish, give you more information about this.
After this interscalene block has been placed, the anaesthetist will start the general anaesthesia.
The hand or arm
Axillary block
In the armpit area, the nerves are located using ultrasound. A local anaesthetic is injected and, if needed, a catheter (a thin tube) is left near the nerves. A pain pump can later be connected to this catheter.
This technique can be used for procedures on the hand and forearm.
The leg
Femoral block
The nerves that supply the leg are located in the groin using ultrasound. This technique can be used for pain relief after knee surgery. A pain pump will then be set up after the procedure.
Either this technique is used on its own, or, as after a total knee replacement, it is combined with a sciatic block, where a nerve is located in the buttock.
Sciatic block
The nerves that supply the leg are located in the buttock using ultrasound. This technique can be used for pain relief after knee surgery. A pain pump will then be set up after the procedure.
Either this technique is used on its own, or, as after a total knee replacement, it is combined with a femoral block, where a nerve is located in the buttock.
The foot
Popliteal block
Certain procedures on the forefoot (corrections at the level of the toes) can be done with a popliteal block. The nerves that supply the foot are located behind the knee using ultrasound.
Ankle block
Certain procedures on the forefoot (corrections at the level of the toes) can be done with an ankle block. The nerves that supply the foot are infiltrated at the level of the foot with local anaesthetic.