Prof. Dr. Erkan Kaptanoğlu

Periferik Sinir Blokları (Enjeksiyon ve Radyofrekans)

The term “nerve block” describes the intervention on the peripheral nerves spread throughout the body. For nerve blocks, local anesthetics are administered in the form of injections. In addition, their analgesic effects typically last beyond the duration of anesthesia caused by the nerve block, providing some patients with pain relief for several weeks or even months. This prolonged analgesia after peripheral nerve blockade may be due to an effect on central pain modulation.

Nerve blocks are a useful treatment option for pain in many parts of the body, such as limb pain, trunk pain, low back pain, side rib pain, etc. In addition, these peripheral nerve procedures can also be effective for primary headache disorders such as migraine and cluster headache.

Radiofrequency neuroablation is the use of extreme heat to achieve the same results as cryonanalgesia and traditional nerve block injection. A probe is placed close to the nerve and radio waves are used to generate heat between 40 and 80 °C at the tip of the probe. This causes destruction of the targeted nerve and pain relief. This procedure is usually done while the patient is under sedation.

Pain from different parts of the body requires different nerve blocks. Examples include the following:

Upper limb

It includes interventions applied to the arms and the neck-arm junction. A brachial plexus nerve block describes intervention at the exit points of the nerves to the arms from the spinal cord. An interscalene block can be performed for the shoulder, clavicle or upper arm. Similarly, supraclavicular block can be performed for the upper arm and infraclavicular block for the elbow and below. A cervical facet block can be performed for the neck.

Neck and back nerve blocks

It is mostly used in neck and back pain. The type of injection is chosen according to the localization of the pain. Cervical epidural injections for the neck and thoracic epidural injections for the upper back and ribs.

Chest and abdominal nerve blocks

Paravertebral block for chest and abdominal pain, intercostal block for chest and ribs, transverse abdominis plane block for lower abdomen, lumbar epidural block for lower back and hip. Celiac plexus block is also performed in this group. Intercostal nerve blocks for shingles pain and costal pain can be applied.

Lower extremity nerve blocks

Hypogastric plexus block for pelvic problems; ganglion impar blocks can be performed for coccyx pain (coccidynia, coxalgia). Lumbar plexus block for the front of the leg including the thigh, knee and below the knee; femoral block for the entire anterior thigh, femur and most of the knee joint and part of the hip joint. Popliteal nerve blocks are performed for below the knee, and sciatic nerve blocks for the leg, lower leg, ankle and back of the foot. A genicular radiofrequency block can be performed for knee pain.

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