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Distal peripheral nerve blockade for patients undergoing hand surgery: a pilot study
José R Soberón1, Neil R Bhatt1, Bobby D Nossaman1
1Department of Anesthesiology, Ochsner Clinic Foundation, 1514 Jefferson Highway, New Orleans, LA 70121 USA.
Hand (New York, N.Y.)
|June 3, 2015
Summary
Forearm nerve blocks are effective primary anesthetics for hand surgery, offering reduced opiate use compared to proximal brachial plexus blocks. These distal blocks provide a safe alternative without respiratory compromise.
Area of Science:
- Anesthesiology
- Regional Anesthesia
- Surgical Anesthesia
Background:
- Limited data exist on forearm peripheral nerve blocks as primary anesthetics.
- Existing studies often categorize them as rescue techniques for incomplete blocks.
Purpose of the Study:
- To investigate forearm nerve blocks for hand surgery.
- To compare distal forearm blocks with proximal brachial plexus blockade.
Main Methods:
- Retrospective review of hand surgery patients receiving peripheral nerve blocks (Nov 2012-Oct 2013).
- Primary outcome: successful primary anesthesia without general anesthesia or supplementation.
- Secondary outcomes: narcotic use, block time, PACU rescue analgesics.
Main Results:
- No significant difference in conversion rates to general anesthesia.
- Lower total opiate administration in the forearm block group.
- No difference in block performance time or PACU rescue analgesic needs.
Conclusions:
- Forearm blocks are viable primary anesthetic alternatives for hand surgery.
- Offer benefits like no respiratory compromise, bilateral potential, and safety in anticoagulated patients.
Keywords:
Forearm blocksHand surgeryMedian (or) ulnar (or) radial nerve blocksRegional anesthesiaUltrasound-guidedMore Related Videos
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