Procedure Overview

We are able to perform many procedures in our procedure suite at the main office if you do not wish to have IV sedation, but if you elect to have IV sedation we will arrange for the procedure to be performed at an ambulatory surgery center (ASC). Our preferred ASC facilities are Queensridge Surgery Center, Box Canyon Surgery Center, and Coronado Surgery Center. Regardless of where your procedure takes place, we will be able to effectively deal with any and all medical emergencies either on-site or upon transfer to a hospital through a pre-arranged protocol. Complications are rare, and occasionally, a patient experiences an exacerbation of a pre-existing medical problem, a reaction to a medication, or an unexpected reaction to an injection. 

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Our staff will inform you of your arrival time when your procedure is scheduled in the office. Arrive with your identification and insurance cards, and once you have checked in with reception you will be escorted to a pre-procedure area. If you elect to have IV sedation, then a nurse will start intravenous access and you will change clothing. You will then be escorted to a procedure room with a fluoroscopy unit (type of x-ray machine). ​

You will be accompanied by a nurse, surgical technician, radiology technician, and Dr. Helmi or Dr. Ruggeroli. If sedation is desired, then a registered nurse will administer this under the supervision of your physician. A separate anesthesiologist is not employed for routine procedures; however, if the procedure requires a surgical incision, then an anesthesiologist will be involved and you will receive a separate bill from the anesthesiologist.

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The skin overlying the anatomic area of the procedure will be prepped and scrubbed with an antiseptic solution. The fluoroscopy unit will be used to assure the precise anatomic location of the injection. A local anesthetic will be used to anesthetize the skin and a small needle will be inserted through the skin. This needle will be directed into the correct location. Contrast will be used to confirm that the needle is correctly placed and only then will the medication be injected. During the injection, you may feel sensations called paresthesias if a nerve is in proximity to the injection site. Some injections, such as disc stimulation, may actually reproduce your typical pain. At the conclusion of the procedure, the needle will be removed and you will be returned to the recovery area. No dressings are usually required.

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Post-procedure your vital signs, neurological examination, and mental capacity will be assessed immediately. The vast majority of patients leave the recovery area after about 30 minutes. If there is any problem, Dr. Ruggeroli or Dr. Helmi will be notified and appropriate treatment will be administered.

If you did not elect to have IV sedation you may drive yourself home after you have been discharged. If you completed your procedure at an ASC and it required IV sedation, then the staff will discharge you after confirming your transportation is present and you will be escorted downstairs and helped into your vehicle. 

 

Most patients do very well after the intervention. Occasionally, side-effects may occur, usually minor reactions to medications, such as nausea, headache or sedation. Rest and time usually resolve these symptoms. Some patients may experience an increase of their typical pain for a few days and it is not uncommon to have some minor pain or swelling at the site of the needle insertion. For these pains, we recommend ice and rest. Any neurological change such as weakness or loss of sensation should be reported immediately. Any problem that persists for more than 24 hours should be reported. The staff at Pain Specialists of Nevada will happily receive your call and will arrange for appropriate medical care if needed.