Jinlei Li, MD, is an anesthesiologist and the director of regional anesthesiology for the Yale New Haven Hospital (YNHH) Saint Raphael Campus. She is a staunch advocate for upper extremity, lower extremity, neck, chest and abdominal nerve blocks for surgical patients.
Nerve blocks are a form of anesthesia that has been increasingly effective in recent years, thanks to the precision of ultrasound guidance, says Dr. Li, who is a leader at Yale in improving pain control around surgery. To administer a nerve block, the anesthesiologist follows a picture on an ultrasound monitor while injecting a hair-thin needle into the affected area of the body, sending non-opioid pain medication to bathe the nerve or nerve bundles that will be affected by the surgery.
So, instead of the sensation of pain traveling along the nerve to the brain, “the brain isn’t getting that message,” Dr. Li says. The approach is becoming a key strategy for providing better post-surgery pain control while minimizing opioid use, which many doctors say contributes to the opioid addiction epidemic.
“If we can better control the acute pain (with a nerve block during surgery), this may ease the transition to chronic pain,” Dr. Li says, adding that the approach is also resulting in shorter hospital stays, easier rehabilitation after surgery, speedier recoveries, and none of the side effects associated with general anesthesia, which affects the entire body. “I had a 79-year-old woman in carotid surgery who received a nerve block instead of general anesthesia, which would have put her to sleep, and later she was smiling in the ICU," Dr. Li says.
An assistant professor of anesthesiology at Yale School of Medicine, Dr. Li has done extensive research on peripheral nerve blocks with local anesthetic adjuvants. She continues to investigate ways to improve their use and effectiveness.