Pre-Operative Instructions: Medial Branch Block

Please pay close attention to the following information/instructions:

If you are currently on antibiotics or being treated for an infection, please call the office prior to your injection appointment.

1. You have been scheduled for a medial branch block. This procedure is a diagnostic injection to test whether or not the facet joints along the spine are a source of your pain.
2. You will be receiving an injection of local anesthetic. The length of pain relief is anticipated to be 4–6 hours only. This procedure is not expected to result in long-term pain relief.
3. You will not be given sedation for this procedure, as you need to be awake and alert immediately following to complete a pain diary form accurately. This form will be given to you and explained on the day of your procedure.
4. We do not anticipate that you will experience any weakness or numbness in the extremities. Nevertheless, it is suggested that you bring a driver to your appointment if possible.
5. On the day of your appointment, please refrain from eating or drinking 4 hours before your appointment time. You may eat and drink immediately following your injection.
6. If you take routine medications, you may take these on the day of your injection as scheduled with a small sip of water.
7. If you are on any blood thinning medication (Plavix^®, Coumadin^®, Aggrenox^®, Lovenox^®, Xarelto^®, aspirin), please notify our office so that we may give you specific instructions about the length of time you need to discontinue these medications. In general, we follow the guidelines below:
   • Plavix^® – Stop for 7 days prior to appointment (you will need clearance from your cardiologist if you have cardiac stents in place)
   • Coumadin^® – Stop 5 days prior to appointment with an INR drawn the day before your appointment.
   • Lovenox^® – Stop 24 hours prior to appointment.
   • Xarelto^® – Stop 3 days prior to appointment.
   • Aggrenox^® – Stop 7 days prior to appointment.
   • Aspirin – For cervical injections, stop 7 days prior. No need to stop before lumbar procedures.
   • Anti-inflammatory (Motrin^®, ibuprofen, Advil^®, Aleve^®, etc.) – For cervical injections, stop 5 days prior. No need to stop for lumbar procedures.