64410 Injection, anesthetic agent; phrenic nerve

Name of the Procedure:

Injection, anesthetic agent; phrenic nerve

Summary

In this procedure, an anesthetic agent is injected near the phrenic nerve to provide pain relief or treat conditions affecting diaphragm function. It is often used to manage chronic pain or breathing difficulties associated with phrenic nerve irritation or injury.

Purpose

The procedure addresses issues like chronic pain and breathing difficulties due to phrenic nerve irritation. The goal is to provide pain relief, improve breathing function, and enhance the patient's quality of life.

Indications

• Chronic pain involving the diaphragm or upper abdomen.
• Diaphragm paralysis or dysfunction causing breathing problems.
• Diagnostic purposes to determine phrenic nerve involvement in symptoms. Patients who have not found relief from other conservative treatments might be candidates for this procedure.

Preparation

• Patients may be advised to fast for several hours before the procedure.
• Medication adjustments might be necessary, especially for blood thinners.
• Pre-procedure tests may include imaging studies and nerve conduction studies to precisely locate the phrenic nerve.

Procedure Description

1. The patient is positioned to allow access to the neck or chest where the phrenic nerve is located.
2. The skin is cleaned and sterilized.
3. A local anesthetic may be applied to numb the injection site.
4. Using imaging guidance (ultrasound or fluoroscopy), a needle is carefully inserted near the phrenic nerve.
5. The anesthetic agent is injected around the phrenic nerve.
6. The needle is removed, and the site is cleaned and bandaged.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

This procedure is usually performed in a hospital, an outpatient clinic, or a specialized surgical center.

Personnel

• An anesthesiologist or interventional pain specialist will perform the injection.
• Nurses will assist with preparation and post-procedure care.

Risks and Complications

• Common risks: Temporary pain or discomfort at the injection site, infection, bleeding.
• Rare risks: Nerve damage, pneumothorax (collapsed lung), allergic reaction to the anesthetic. Complications, if they arise, are managed based on severity and symptoms.

Benefits

• Pain relief: Typically noticed within a few days.
• Improved breathing function: Can be immediate or gradual.
• Enhanced quality of life due to reduced symptoms.

Recovery

• Post-procedure monitoring for a few hours to ensure there are no immediate complications.
• Patients can usually return home the same day.
• Instructions may include rest, avoiding strenuous activities, and follow-up appointments as needed.

Alternatives

• Oral or systemic pain medications.
• Physical therapy for diaphragm strengthening.
• Surgical interventions in severe cases. Each alternative has its own set of advantages and disadvantages, and a healthcare provider can help determine the best course of action.

Patient Experience

During the procedure, patients may feel slight pressure or discomfort when the needle is inserted. Pain management techniques include local anesthesia to ensure patient comfort. Post-procedure, mild soreness at the injection site is common and can be managed with over-the-counter pain relievers. Most patients experience a significant reduction in pain and improvement in symptoms within days to weeks after the injection.