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Anesthesiology/Peripheral nerve block, arm surgery


When I had a severe break of My arm at the wrist (collies fracture) I required immediate setting of the bone, followed later by surgery to repair it and allow for proper healing. A metal plate was drilled to the radius to fixate the unstable fracture.
I had asked specifically for a PNB in addition to general anesthesia but was refused the PNB. I protested saying I knew I'd be in agony following surgery and had been having involuntary jerks and movements of the arm (awake, but mostly during sleep), so why no one? I wasn't given an explanation.
Was the doctor just being a sadist? He had been a huge, unreasonable jerk to me concerning other matters prior...
Still just wondering "why"?

Hey Amanda

Sorry for the late reply I was away!

That sounds like a horrible experience. I will say that it is not uncommon for anesthesia to not perform a PNB after a trauma. This happens because of concerns of nerve injury from the trauma itself AND the surgery to repair it. So what often happens is that a PNB is not done prior to surgery but done after the surgery and after a nerve assessment is completed.

Why your provider would not perform a block after the procedure and an assessment of your nerves I do not understand unless there is something else im not aware of.

Sorry you had to endue that pain and frustration!


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Mike MacKinnon MSN FNP-C CRNA


I am a former Trauma Flight RN now a Family Nurse Practitioner and a Nurse Anesthetist (CRNAs). I can help answer questions on the CRNA profession and clinical anesthesia. I work full time as an independent practice CRNA and have a special interest in regional anesthesia, particularly peripheral nerve blocks. I also teach ultrasound regional anesthesia and lecture all over the country. If I do not know the answer, I will find it for you.


I am a Family Nurse Practitioner and a Nurse Anesthetist who works as an independent/autonomous practitioner. There are often questions about my profession and I would like to offer the service of an actual CRNA. If you did not know, there are about 40000 of us which equates to 50% of the anesthesia providers in the USA today. I also lecture and teach ultrasound regional anesthesia all over the country.

AANA (American Association of Nurse Anesthetists)
IARS (International Anesthesia Research Society) AANP (American Association of Nurse Practitioners)

Air Medical Transport Journal
OutPatient Surgery Magazine

Bachelors of Science in Nursing
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