Nerve Blocks Expand Interventional Radiology’s Role in Pain Management

Pain management is an essential aspect of modern medicine. It’s also one rife with challenges, such as concerns about opioid overuse and the need to tailor therapies for diverse patient populations.

Interventional radiology (IR) is helping answer these challenges.

“In today’s evolving pain management landscape, interventional radiology is emerging as a key player in providing targeted analgesia through minimally invasive techniques,” said Edward Yoon, MD, chief of interventional radiology at the Hospital for Special Surgery in New York.

Once the domain of anesthesiologists and pain specialists, a growing emphasis on opioid- sparing strategies that prioritize safety while maintaining adequate analgesia has seen interventional radiologists move into the pain management arena.

Among the techniques helping expand IR’s role in pain management are nerve blocks.

According to a recent RadioGraphics article by Kenneth N. Huynh, DO, of the University of California, Irvine, and colleagues, nerve blocks are an opioid-sparing analgesic technique that plays a critical role in multimodal pain management.

Nerve blocks work by injecting a local anesthetic, often with adjuncts, around a specific nerve or plexus to temporarily interrupt nociceptive transmission to the central nervous system. By blocking voltage-gated sodium channels, nerve blocks prevent neuronal depolarization and pain signal propagation, resulting in a loss of sensory transmission in the targeted region.

While different approaches can be used—many of which are described by Dr. Huynh and his coauthors—all nerve blocks depend on proper technique and needle trajectory, image guidance (US, CT, fluoroscopy) and safety. As to the latter, slow, controlled injections are critical to preventing complications.

A Targeted Approach to Relief

The authors note that nerve blocks provide targeted pain relief, often without the need for deep sedation. They are particularly beneficial in patients who may not be suitable candidates for systemic opioid therapy due to contraindications or risk of adverse effects.

In some cases, nerve blocks can last up to 24 hours, providing pain relief well after a procedure is complete.

Those benefits have prompted growing interest in incorporating nerve blocks into IR practice.

“Integrating nerve blocks into our own clinical practice allows us to avoid deep sedation, as well as general anesthesia, and instead do these procedures in an outpatient setting while ultimately providing our patients with better, longer-lasting pain control after the procedure,” Dr. Yoon explained.