FAQ Based Instructions

1
What Should I expect after an Interscalene/supraclavicular block is finished?
As the numbing medication takes effect, you will notice a gradual numbing sensation in the shoulder and arm. Typically, people are still able to move their fingers (which may feel "tingly"), but temporarily lose the ability to lift or move the arm or shoulder itself. It is important that you don't try to move your arm without direction from the medical staff as you might unintentionally injure yourself. After surgery, a sling will be used to safely support your arm. After you are discharged from the hospital you should avoid exposing your arm to extremes in temperature until full sensation in your shoulder has returned.
2
How long will it take for the block to start working?
The onset of the Interscalene/supraclavicular block varies depending on the type of numbing medication that is used. Usually, a combination of mepivicaine and ropivicaine is used. Lidocaine usually starts to work in 5-15 minutes, while ropivicaine starts to work in 20-30 minutes. Mepivicaine is used to get the block working sooner, while ropivicaine keeps the block working longer.
3
How long does the block last?
The duration of action of the Interscalene/supraclavicular block depends on the mixture of the numbing medications used by the anesthesia staff. Usually, a combination of mepivicaine and ropivicaine is utilized resulting in approximately 8-12 hours of pain relief. However, patients metabolize (eliminate) the medications at varying rates, and the actual duration of the block can vary greatly from person to person. Typically, you can expect the block to be maximally effective for at least 6 hours after it is placed.
4
Are there any side-effects associated with the interscalene/supraclavicular block?
There are a number of expected side-effects with the use of the interscalene/supraclavicular block because the brachial plexus also contains other types of nerves that will be affected by the injected medication. Each of these temporary side-effects is expected to resolve completely once the block has worn off.

You may notice some bruising or swelling at the site of injection. Numbing of the sympathetic nerves that supply your face may cause temporary drooping of your eyelid, a smaller pupil size and a decrease in sweating along the same side of your face as the operative arm. Numbing of the recurrent laryngeal nerve may cause your voice to sound hoarse or "raspy". Your throat will not hurt, but the sound of your voice may temporarily change.

Numbing of the phrenic nerve will cause dysfunction of the diaphragm muscle on the same side of the block. This means that one of your lungs will not expand as effectively as usual for the duration of the block. If you have normal lung function, you should not notice any change in your ability to breathe normally. You may, however, experience slight difficulty when attempting to take a full, deep breath. Certain lung conditions, such as COPD or emphysema, or a history of heavy smoking, may pose other risks in association with use of this block. Please alert the medical staff if you have a history of lung disease, heavy smoking or breathing problems.

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