What are the indications of selective nerve root blocks (SNRBs) in pain management?

Updated: Jun 19, 2018
  • Author: Anthony H Wheeler, MD; Chief Editor: Meda Raghavendra (Raghu), MD  more...
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Selective nerve root blocks (SNRBs) are often useful diagnostically and prognostically as part of a surgical work-up. Some experts advocate that deposition of a small amount of corticosteroids might produce a therapeutic effect. The therapeutic application of LAs and corticosteroids may provide short-term relief for presurgical reconditioning or as part of a nonoperative treatment plan, to reduce pain while initiating a physical therapy or functional restoration program.

Because selective nerve root blocks are often performed for diagnostic purposes, only small quantities of LA should be used to prevent any confusion that may occur if anesthesia spreads to adjacent nerve roots simultaneously. Nerve roots are identified by eliciting dermatomal paresthesia; radiographic confirmation is useful to ascertain the level and to prevent needle injury to the target nerve root.

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