Interventional Procedures for Pain
Click on the document below to review what procedures we offer and how they are done. We do not use sedation for any office based procedure as it adds risk without benefit. Procedures performed with local anesthetic are well tolerated, much safer, and less costly.
At this time there is great controversy regarding a need to stop blood thinners prior to certain procedures. Competing guidelines are different on what procedures and what medications need to be stopped. The risk of stopping blood thinners includes heart attack and stroke resulting in death. The risk of continuing blood thinners includes bleeding in the area of the injection that may result in surgery or increased pain. I no longer require patients to stop blood thinners unless we are doing spinal stimulators, kyphoplasty, discography, or sympathetic blocks. I am comfortable performing epidural injections, RF (nerve burning procedure), and all other injections useing small needles while patients are on blood thinners.
For knee pain that did not improve after a knee replacement surgery. We do a single diagnostic block to see if the RF will have a lasting effect.
Knee presentation patient handout.pdf
Adobe Acrobat document [724.2 KB]
Lobel SSNB Presentation.pptx
Microsoft Power Point presentation [1.6 MB]
Here is a presentation I put together to teach pain doctors how to do the procedure.
Parallax Workshop Presentation - lobel.p[...]
Microsoft Power Point presentation [8.8 MB]
Video Link Sphenopalatine Ganglion Block
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