Precision Meets Pain Relief: Image-guided Nerve Blocks in Interventional Radiology

Nerve blocks are a valuable opioid-sparing analgesic technique that play a critical role in multimodal pain management. As interventional radiology continues to expand its scope, proficiency in nerve block techniques has become increasingly relevant. Unlike general anesthesia, nerve blocks provide targeted pain relief, facilitating procedural success while minimizing systemic opioid use and associated complications as well as decreasing health care costs. The authors provide an in-depth discussion of nerve block mechanisms, indications, procedural techniques, imaging guidance, and safety considerations. The primary categories of nerve blocks covered are autonomic, mixed autonomic and peripheral somatic, peripheral somatic, fascial plane, and motor blocks, with emphasis on their clinical applications in interventional radiology practice. Additionally, pharmacologic considerations, including local anesthetic selection and adjunctive agents, are reviewed to optimize efficacy and duration of analgesia. Complications such as intravascular local anesthetic injection, collateral tissue injury, and local anesthetic systemic toxicity are discussed in detail, along with prevention and management strategies. Emerging applications of nerve blocks, including their role in oncologic pain management and palliative care, are also discussed. Proper documentation, adherence to coding guidelines, and an understanding of billing considerations are required to ensure appropriate reimbursement and compliance. By incorporating nerve blocks into practice, interventional radiologists can improve patient comfort, procedural efficiency, and overall clinical outcomes. The authors provide a foundational resource for interventional radiologists seeking to integrate nerve block techniques into their clinical practice and facilitating their contribution in multimodal pain management strategies.