Nerve Block Template

Procedure Note

Occipital nerve block, left side

Patient ID was confirmed. Patient was counseled on risks that include pain and bleeding. They wanted to proceed.

A solution of 1ML of 40mg/ml Kenalog, 0.5 ml of Bupivacaine 0.5% and 0.5ml of lidocaine 1% were mixed together per occipital nerve block protocol at Reid. Isopropyl

alcohol was used for antisepsis.

Using 25G needles the 2-3 sites were injected per side, with 2ml of the solution detailed above injected per side along the occipital groove.

The patient tolerated with procedure well without complications and was discharged from the clinic