Interscalene Nerve Blocks for Shoulder Surgery
Better Pain Control for a More Comfortable Recovery
Many patients undergoing shoulder surgery at Midwest Orthopedic & Musculoskeletal Alliance (MOMA) receive an interscalene nerve block as part of their anesthesia and pain management plan. This advanced regional anesthesia technique provides excellent pain relief during and after surgery, helping patients recover more comfortably while reducing the need for opioid pain medications.
Our fellowship-trained orthopedic surgeons work closely with our highly specialized anesthesia team to determine whether an interscalene block is appropriate for your procedure and your individual health needs.
What Is an Interscalene Nerve Block?
An interscalene nerve block is a procedure that temporarily numbs the nerves that provide sensation to the shoulder and upper arm.
Before surgery, a local anesthetic is carefully placed around these nerves in the side of the neck. This blocks pain signals from reaching the brain while allowing your surgery to be performed with significantly less discomfort after the procedure.
Most patients experience numbness and pain relief for several hours after surgery, although the exact duration depends on the medications used.
Ultrasound-Guided Precision
At MOMA, our experienced anesthesia providers use real-time ultrasound guidance to perform interscalene nerve blocks.
Ultrasound allows the anesthesiologist to clearly visualize the nerves, surrounding blood vessels, muscles, and other important structures during the procedure. This technology improves precision, increases the likelihood of a successful block, and helps minimize the risk of complications.
The block is performed before surgery while you are awake but made as comfortable as possible. Mild sedation may be given if needed.
Continuous Interscalene Catheters
For some patients—particularly those undergoing more extensive shoulder procedures or those expected to have significant postoperative discomfort—your anesthesiologist may recommend placing a continuous interscalene catheter.
A very small, flexible catheter is positioned next to the nerves using ultrasound guidance. A portable pump slowly delivers local anesthetic over the next 48 to 72 hours, providing continuous pain relief during the time when postoperative discomfort is often greatest.
The catheter is designed to be lightweight and portable so you can recover comfortably at home. You and your caregiver will receive detailed instructions on caring for the catheter and safely removing it when the infusion is complete.
Not every patient requires a continuous catheter. Your anesthesia team will discuss whether this option is appropriate for your surgery and medical history.
Benefits of an Interscalene Block
An interscalene block offers many advantages for patients undergoing shoulder surgery, including:
- Excellent pain relief during and after surgery
- Reduced need for opioid pain medications
- Less nausea and constipation associated with narcotic medications
- Greater comfort during the first several days of recovery
- Earlier participation in physical therapy and rehabilitation
- Improved ability to rest and sleep following surgery
- Higher patient satisfaction with postoperative pain control
- In many cases, the ability to return home comfortably on the day of surgery
For patients receiving a continuous catheter, these benefits may continue through the first 2 to 3 days after surgery.
What Will I Feel After the Block?
After your block is placed, it is normal to experience:
- Numbness in the shoulder and upper arm
- Weakness or temporary inability to lift the arm
- A “heavy” feeling in the arm
- Warmth or tingling as the medication begins to work
These effects are expected and gradually wear off as the anesthetic wears off.
Your surgeon will provide instructions on protecting your arm while it is numb to avoid accidental injury.
Possible Side Effects
Most side effects are temporary and resolve as the block wears off.
Common temporary effects include:
- Hoarseness
- Mild drooping of the eyelid on the same side
- Nasal congestion
- Temporary shortness of breath caused by partial numbing of the diaphragm
- Temporary arm weakness or numbness
These effects typically improve as the local anesthetic wears off.
Patients with significant underlying lung disease may not be ideal candidates for this type of nerve block. Your anesthesia team will carefully review your medical history before recommending the procedure.
Potential Risks
Serious complications are uncommon, particularly when the block is performed by experienced anesthesia providers using ultrasound guidance. However, every medical procedure carries some risk.
Potential complications include:
- Bleeding or bruising
- Infection
- Injury to nearby blood vessels
- Temporary or, very rarely, permanent nerve injury
- Incomplete pain relief requiring additional medications
- Allergic reaction to local anesthetic medications
- Local anesthetic entering the bloodstream (a rare but potentially serious complication)
- Lung injury (pneumothorax), which is extremely uncommon with modern ultrasound-guided techniques
Your anesthesia provider will discuss these risks with you before surgery and answer any questions you may have.
Our Commitment to Safe, Effective Pain Management
At Midwest Orthopedic and Musculoskeletal Alliance, patient comfort and safety are always our highest priorities.
Our dedicated orthopedic anesthesia team has extensive experience caring for patients undergoing shoulder surgery. By combining ultrasound-guided regional anesthesia, advanced pain management techniques, and close collaboration with your surgeon, we strive to provide outstanding pain control while minimizing medication side effects and helping you begin your recovery as comfortably as possible.
If you have questions about anesthesia or nerve blocks before your procedure, our team will be happy to discuss your options and help you understand what to expect.
Questions about the interscalene block?
If you have questions about shoulder surgery anesthesia or would like to schedule a consultation, contact Midwest Orthopedic and Musculoskeletal Alliance today at 414-384-6700. Our team in Southeastern Wisconsin is here to help.