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Ang iyong nerve block sa balikat

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Ang nerve block na ginagamit namin para sa operasyon sa balikat — kung paano ito nagpapabango sa iyong braso, bakit ito epektibo sa pagkontrol ng sakit, at ano ang inaasahan habang ito ay unti-unting nawawala.

Illustrasyon ng isang anestesista na gumagamit ng ultrasound probe sa gilid ng leeg ng isang nakarelaks na pasyente, kaunti sa itaas ng collarbone, upang maglagay ng nerve block.
Isang ultrasound-guided block: inilalagay ang local anaesthetic sa paligid ng mga nerbiyos sa itaas ng collarbone, na nagpapabango sa buong braso sa loob ng ilang oras. Kieran Hirpara 4.0

Ang pahinang ito ay isinalin ng makina at hindi pa nasusuri ng isang doktor. Ang bersyong Ingles ang siyang opisyal.

Halos lahat ng operasyon sa balikat ay ginagawa kasama ang nerve block at isang magaan na pangkalahatang anestesia. Ang block ang pinakaepektibong paraan na mayroon kami upang panatilihing komportable ka pagkatapos ng operasyon, at mahalagang maunawaan ang plano upang hindi ka mapagbiglang-ibahin ng anumang bagay.

Ano ang nerve block

Lahat ng mga nerbiyos na nagbibigay-suplay sa iyong braso ay dumadaan sa isang masikip na bundle (bundel) sa itaas ng iyong collarbone. Gamit ang ultrasound machine upang makita kung saan eksaktong nasa loob sila, inilalagay ng anaesthetist ang kaunting local anaesthetic sa paligid ng bundle na iyon. Ito ay tinatawag na supraclavicular block. Pinapahinto nito ang mga signal ng sakit mula sa buong braso sa loob ng ilang oras, sapat na para sakopin ang iyong operasyon at ang unang bahagi ng iyong paggaling, kung saan kung hindi ito gagawin, ang sakit ay maaaring maging pinakamasama.

Hindi ka gising sa panahon ng operasyon. Karaniwan, kakailanganin mo ng magaan na general anaesthetic sa ibabaw ng block, upang matulog ka habang ginagawa ang operasyon. Ang block ang nagbibigay ng pagpapagaan ng sakit; ang general anaesthetic ang nagpapanatili sa iyo na komportableng natutulog.

Bakit ito ang ginagamit para sa iyong balikat

Ang isang mahusay na block ay higit pa sa simpleng pamamanhid ng isang karayom:

  • Mas epektibo ito sa pagkontrol ng sakit kaysa sa mga tablet o sa paggamit ng general anaesthetic lamang. Sa maraming pag-aaral, ang mga pasyenteng nakatanggap ng brachial plexus block ay may mas mababang antas ng sakit sa mga unang oras pagkatapos ng operasyon sa balikat at nangangailangan ng mas kaunting malakas na gamot pang-alis ng sakit. Isang pagsusuri na nag-umpisa sa 36 hiwalay na pag-aaral at higit sa 3,000 na pasyenteng nakapagpasok ng keyhole shoulder surgery ay nagpakita na ang mga brachial plexus block tulad nito ay nagbaba ng antas ng sakit at nagbawas ng dami ng malakas na opioid painkiller na kailangan pagkatapos ng operasyon.
  • Pinapayagan nitong magbigay kami ng mas magaan na general anaesthetic. Dahil ang block ang nagtatrabaho nang mabigat sa pagkontrol ng sakit, karaniwang gumising ka nang mas malinaw, may mas kaunting pagka-groggy at mas kaunting pagsusuka.
  • Binabawasan nito ang dami ng opioid (malakas na gamot pang-alis ng sakit) na kailangan mo. Ibig sabihin, mas kaunting side effects (mas kaunting constipation, pagka-drowsy at pagsusuka) at mas maayos na maagang paggaling.
  • Pinapabilis nito ang pagiging komportable, paggalaw, at pag-uwi.

Pakiramdam

Sa loob ng humigit-kumulang 20–30 minuto pagkatapos ng injeksyon, mabigat, mainit, pamamanhid, at mahina ang braso. Hindi mo ito makakataas o hindi mo maramdam nang mabuti, at maaaring hindi mo makakagalaw ang mga daliri. Ito ang eksaktong nangyayari. Karaniwang tumatagal ang pamamanhid ng 8 hanggang 18 oras, minsan ay hanggang isang araw. Ganap itong pansamantala: bumabalik palagi ang buong pakiramdam at galaw.

Bakit kailangan mong magsuot ng sling

Habang aktibo pa ang block, numb ang iyong braso at walang sarili nitong lakas. Ang sling ay para hawakan at protektahan ito, upang hindi ito mahulog, malantad, o matamaan, at upang hindi ka umuungol o umiikot sa isang braso na hindi mo nararamdaman. Panatilihing suporta sa sling, panatilihing mainit, at huwag hayaang bitbitin ito pababa. Isipin mo ito bilang pag-aalaga sa isang bahagi ng katawan na hindi pa kayang alagaan ang sarili nito.

Mga bagay na maaari mong mapansin (karaniwan ito)

Dahil malapit ang mga nerbiyos na pinapabayaan sa leeg sa iba pang mga nerbiyos, maaaring mapansin mo ang ilang walang panganib at pansamantalang epekto sa gilid na iyon:

  • isang bumababa o mabigat na talukap ng mata, at minsan ay bahagyang pamumula ng mata
  • bahagyang bulong na boses o pakiramdam ng siksikan sa ilong
  • pakiramdam na hindi mo kayang kumuha ng ganap na malalim na hinga (maaaring pansamantala pumahina ang nerbiyong nagmumotorsay sa kalamnan sa ilalim ng baga mo sa gilid na iyon)

Ang supraclavicular na paraan na aming ginagamit ay pinili nang bahagya dahil mas bihira nitong sanayin ang mga epektong ito kumpara sa mga block na inilalagay nang mas mataas sa leeg. Lahat ito ay mawawala kasabay ng paglabas ng block, at hindi nangangailangan ng anumang paggamot.

Kapag nawala ang epekto ng block — simulan na ang pag-inom ng iyong mga tabletang pang-alis ng sakit

Ito ang pinakamahalagang bahagi na dapat gawing tama.

Mahusay ang block para sa unang 8–18 na oras, at pagkatapos ay bumabalik ang pakiramdam, madalas sa gabi. Habang ito ay nangyayari, maaaring biglang dumating ang sakit. Tinatawag itong rebound pain, at nakakapagpagulo ito dahil komportable ang mga tao bago ito nangyari.

Ang simpleng solusyon ay: huwag hintayin ang sakit. Inumin ang iyong mga regular na reseta ng mga tabletang pang-alis ng sakit bago ganap na gumising ang iyong braso: bibigyan ka namin ng humigit-kumulang oras kung kailan ito mangyayari, at patuloy na inumin ang mga ito nang regular sa unang ilang araw, kahit naka-numb pa ang iyong braso. Ang mga pasyenteng nakakapanalo dito ay may mas maayos na unang gabi. Ang mga pasyenteng naghihintay hanggang dumating ang sakit ay may masasakit na ilang oras habang sinusubukan pangakuin ang napalampas na.

Tumawag sa amin o humingi ng tulong kung

  • napakahirap ng iyong paghinga o lumalala ito (karaniwang inaasahan ang bahagyang pakiramdam na hindi puno ang iyong baga; ang tunay na hirap sa paghinga ay hindi: kailangan ng pagsusuri)
  • patuloy kang ganap na walang pakiramdam at malambot ang iyong braso pagkatapos ng 24–30 oras
  • nagiging puti, malamig, o asul ang iyong mga daliri, o mayroon kang sakit sa dibdib

Para sa karaniwang rebound pain habang unti-unting nawawala ang block, uminom ng iyong mga tablet at manatiling harapin ito: ito ay mamumuti sa susunod na isang araw o dalawa.

Reviewed by Dr Kieran Hirpara · 22 June 2026.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

Key Evidence

Brachial plexus blocks reduce pain and opioid use after shoulder surgery. Regional anaesthesia is the cornerstone of modern shoulder-surgery analgesia. A current review of regional techniques for shoulder surgery describes the supraclavicular brachial plexus block as an effective approach that provides dense analgesia of the arm while producing fewer of the unwanted neck-related effects (hoarseness, Horner's syndrome, diaphragm involvement) seen with higher interscalene blocks [1]. Across the broader literature, peripheral nerve blocks consistently lower early post-operative pain scores and reduce opioid consumption compared with general anaesthesia or local infiltration alone [2,3,5].

The benefit is largest in the first hours and translates into better recovery quality. A systematic review and meta-analysis in Anesthesiology found brachial plexus and suprascapular blocks deliver clinically meaningful analgesia for shoulder surgery, supporting their routine use [2]. A focused review of regional blocks for arthroscopic rotator cuff repair reached the same conclusion: blocks improve early pain control and reduce rescue-opioid requirements [3]. Longer-acting block formulations further extend the pain-free window after shoulder replacement [4].

Rebound pain is real and is best managed by pre-emptive oral analgesia. Because a single-shot block wears off after roughly 8–18 hours, patients can experience a sharp surge of pain as sensation returns — usually overnight. A two-centre randomised controlled trial and the wider rebound-pain literature emphasise that patient education and starting regular analgesia before the block resolves are central to a smooth recovery [6]. This is why patients are advised to begin their prescribed pain tablets early rather than waiting for pain to arrive.

References

  1. Zhang LL, Sinha SK, Murthi AM. Current Strategies in Regional Anesthesia for Shoulder Surgery. J Am Acad Orthop Surg. 2025;33(14):761-9. doi:10.5435/JAAOS-D-24-00738
  2. Hussain N, Goldar G, Ragina N, et al. Suprascapular and Interscalene Nerve Block for Shoulder Surgery: A Systematic Review and Meta-analysis. Anesthesiology. 2017;127(6):998-1013. doi:10.1097/ALN.0000000000001894
  3. Kim TY, Hwang JT. Regional nerve blocks for relieving postoperative pain in arthroscopic rotator cuff repair. Clin Shoulder Elb. 2022;25(4):339-46. doi:10.5397/cise.2022.01263
  4. Finkel KJ, Walker A, Maffeo-Mitchell CL, et al. Liposomal bupivacaine provides superior pain control compared to bupivacaine with adjuvants in interscalene block for total shoulder replacement: a prospective double-blinded, randomized controlled trial. J Shoulder Elbow Surg. 2024;33(7):1512-20. doi:10.1016/j.jse.2023.12.014
  5. Liu Z, Li YB, Wang JH, et al. Efficacy and adverse effects of peripheral nerve blocks and local infiltration anesthesia after arthroscopic shoulder surgery: A Bayesian network meta-analysis. Front Med (Lausanne). 2022;9:1032253. doi:10.3389/fmed.2022.1032253
  6. Uppal V, Barry G, Ke JXC, et al. Reducing rebound pain severity after arthroscopic shoulder surgery under general anesthesia and interscalene block: a two-centre randomized controlled trial of pre-emptive opioid treatment compared with placebo. Can J Anaesth. 2024;71(6):773-83. doi:10.1007/s12630-023-02594-0

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