64415 Injection(s), anesthetic agent(s) and/or steroid; brachial plexus

Name of the Procedure:

Injection(s), anesthetic agent(s) and/or steroid; brachial plexus

Summary

A brachial plexus injection involves administering anesthetic agents and/or steroids near the brachial plexus nerves, which are a network of nerves that send signals from your spine to your shoulder, arm, and hand. This procedure aims to relieve pain and inflammation in these regions.

Purpose

This procedure is used to manage and treat chronic pain and inflammation in the arm, shoulder, and hand. The goals are to reduce pain, improve mobility, and enhance the overall quality of life for patients experiencing these symptoms.

Indications

• Chronic shoulder, arm, or hand pain
• Inflammatory conditions such as brachial plexitis
• Post-surgical nerve pain
• Brachial plexus neuropathy
• Failed conservative treatments

Preparation

• Fasting may be required for a few hours prior to the procedure.
• Adjustments to medications, particularly blood thinners, may be needed.
• A pre-procedure assessment, which may include imaging studies like MRI or ultrasound, to locate the exact site for injection.

Procedure Description

1. The patient is positioned appropriately, usually lying down.
2. The skin around the injection site is sterilized.
3. Local anesthesia may be applied to the skin to minimize discomfort.
4. Using imaging guidance (like ultrasound or fluoroscopy), the physician inserts a needle near the brachial plexus.
5. Anesthetic and/or steroid medication is injected through the needle.

6. The needle is removed, and the injection site is covered.

   Tools used include needles, syringes, anesthetic agents, steroids, and imaging devices. Patients typically receive local anesthesia, though sedation may be used in some cases.

Duration

The procedure usually takes about 30 minutes to an hour.

Setting

This procedure is commonly performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Interventional Pain Specialist or Anesthesiologist
• Nurse
• Radiologic Technologist (if imaging guidance is used)

Risks and Complications

• Infection at the injection site
• Bleeding or bruising
• Nerve damage
• Allergic reaction to medication
• Temporary increase in pain

Complications are rare but can be managed through appropriate medical intervention.

Benefits

• Significant pain relief
• Reduced inflammation
• Increased mobility and function
• Improvement in daily activities

Benefits might be realized within a few days to weeks after the procedure.

Recovery

• Mild soreness at the injection site is common.
• Rest and avoid strenuous activity for 24-48 hours.
• Apply ice to reduce swelling if needed.
• Follow-up appointments to monitor progress.

Patients may return to normal activities within a few days, and full recovery is typically expected within a week.

Alternatives

• Oral medications (pain relievers, anti-inflammatories)
• Physical therapy
• Other types of nerve block injections
• Surgical intervention

Each alternative has its own set of benefits and drawbacks, often depending on the severity and specific condition being treated.

Patient Experience

During the procedure, patients might feel a slight discomfort or pressure when the needle is inserted. Post-procedure, mild soreness or bruising may occur at the injection site, which can be managed with ice packs and over-the-counter pain relief. Most patients experience a significant reduction in pain within a few days.