Landmark Technique for a Wrist Block

JBJS Essential Surgical Techniques
Alex Kocheta, Yuvraj Agrawal

Abstract

Effective anesthesia of the hand and wrist has many uses inside and outside the operating room. In the emergency department or fracture clinic, a wrist block may be used for closed reductions of dislocations and fractures or for effective inspection and treatment of wounds. In the operating room, surgery may be carried out under a wrist block alone or a wrist block may be used as an adjunct to general anesthesia as the block is an opiate-sparing option to facilitate outpatient surgery and to provide many hours of postoperative analgesia, particularly if administered prior to the commencement of surgery. The landmark technique for distal peripheral nerve blocks at the wrist is a well-recognized method and is described for the median nerve, ulnar nerve, superficial branch of the radial nerve, and dorsal branch of the ulnar nerve at the wrist. To make this technique more effective for carpal surgery, blocks of the posterior interosseous and anterior interosseous nerves are added.Step 1: The patient is counseled about the procedure and the expected outcomes.Step 2: Drug allergies are checked.Step 3: The maximum safe dose of the chosen local anesthetic agent is calculated using the weight of the patient.Step 4: The drug ampules are ...Continue Reading

References

Dec 1, 1995·The Journal of Hand Surgery : Journal of the British Society for Surgery of the Hand·A FerreresD Ruano
May 15, 2004·The Journal of Hand Surgery : Journal of the British Society for Surgery of the Hand·D L WallaceH J C R Belcher
Dec 7, 2010·The British Journal of Oral & Maxillofacial Surgery·Branislav V Bajkin, Ljubomir M Todorovic

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Citations

Jan 4, 2020·Operative Orthopädie und Traumatologie·Mohammad Tezval, Christopher Spering

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