What is an intravenous regional block?
The term intravenous regional block refers to a procedure where drugs are
injected into a vein (intravenous) in your arm or leg (the ‘region’ of your body).
The drugs injected will be either:
· Local anaesthetic and guanethidine
· Local anaesthetic and ketorolac
Why do I need an intravenous regional block?
Intravenous regional blocks are sometimes used to relieve pain for certain
conditions affecting the limbs. They can be used for both arm and leg
problems. The block may not cure your pain, but may relieve some or all of
your pain for a time, allowing you to increase your mobility and loosen stiff
joints and muscles that have not been used for a while. You may have a
series of blocks over a number of weeks.
What happens on the day of treatment?
The procedure is carried out as a day case and hospital admission is usually
for a morning or afternoon only.
On arrival, a nurse will ask you a few brief questions. You will then be asked
to put on a theatre gown and your pulse and blood pressure will be recorded.
Your Pain Consultant will then discuss the procedure with you and you will be
asked to sign a consent form.
The procedure itself is carried out in the operating theatre. This allows for the
block to take place in a clean environment with appropriate care and
On entering the theatre, a small needle will be placed in the painful limb and
another in the back of your hand to give you sedation or emergency drugs if
The procedure is generally performed with you lying on your back. A
tourniquet (like a blood pressure cuff) will be placed on the upper part of your
painful limb. Your limb will be raised to allow the blood to drain out and then
the cuff is inflated. You may feel a sensation of tightness around the upper
part of the limb and some discomfort.
Local anaesthetic and guanethidine or local anaesthetic and ketorolac is then
injected through the needle in your painful limb.
The local anaesthetic may work immediately to relieve some or your pain.
Guanethidine is thought to work by reducing the overactivity in the nerve
endings involved in the control of blood flow and pain in the limb.
Ketorolac works by reducing the level of inflammatory chemicals involved in
the transmission and maintenance of pain.
During the procedure, a burning sensation and pins and needles may be
experienced and your limb may become mottled or blue in colour. This is
normal, but if you find it uncomfortable you should let the doctor know and you
may be given some sedation to relax you and make you feel sleepy.
The tourniquet remains inflated for about 20-30 minutes. After this time it is
After the procedure, you will be taken to the recovery area within the theatre
suite. Here, your blood pressure will be monitored for a short period of time.
You will remain on the bed/trolley for around 30 minutes. Your blood pressure
will be checked before you get up.
Pain relief may occur after only 1 treatment or following 2 or 3 treatments. The
pain relief may last for several days to weeks or months.
It is important that you use your painful limb as normally as possible to gain
the full benefit from any pain relief the block has given and decrease any
You may have a bath or shower immediately and will be able to return to all
your usual activities the following day.
An exception to this is driving. If you have had sedation you should not drive
for 24 hours and will need a friend or relative to go home with you.
Potential complications of intravenous regional blocks
Occasionally, the blocked nerves may affect the width of your blood vessels,
causing your blood pressure to fall. Sometimes you may feel faint. This
generally requires no treatment and will return to normal in a few minutes.
You may experience changes in colour or a feeling of warmth in the limb.
With any type of injection there is a risk of infection. Over the next few days
you should observe if the area around the injection becomes painful and
swollen, red, hot to touch or ‘weepy’.