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Landmark Technique for a Wrist Block.

Alex Kocheta1, Yuvraj Agrawal2

  • 1Rotherham General Hospital, Rotherham, United Kingdom.

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Summary

This study details the landmark technique for wrist blocks, an effective anesthesia method for hand and wrist procedures. It offers a rapid, inexpensive, and opiate-sparing option with minimal motor block, suitable for various clinical settings.

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Area of Science:

  • Anesthesiology
  • Orthopedic Surgery
  • Pain Management

Background:

  • Effective anesthesia of the hand and wrist is crucial for both operative and non-operative procedures.
  • Wrist blocks offer an opiate-sparing alternative to general anesthesia, facilitating outpatient surgery and providing prolonged postoperative analgesia.
  • The landmark technique is well-established for blocking key nerves in the wrist.

Purpose of the Study:

  • To describe the landmark technique for performing wrist blocks for anesthesia and analgesia.
  • To highlight the utility of wrist blocks in various clinical settings, including emergency departments and operating rooms.
  • To detail the steps and considerations for effective and safe wrist block administration.

Main Methods:

  • Patient counseling, allergy verification, and calculation of maximum local anesthetic dose.
  • Identification of anatomical landmarks and at-risk structures for each of the six targeted nerves.
  • Antiseptic skin preparation followed by nerve block injections, with vigilance for intraneural or intravascular administration.

Main Results:

  • The landmark technique effectively provides anesthesia for hand and wrist procedures.
  • Wrist blocks are rapid, inexpensive, and require minimal equipment, making them suitable for austere environments.
  • The technique results in minimal motor block, allowing for intraoperative active motion and immediate postoperative physiotherapy.

Conclusions:

  • The landmark technique for wrist block is a valuable and versatile anesthesia method.
  • Potential complications include failure of analgesia, intraneural injection, and direct nerve injury, necessitating careful technique.
  • The minimal motor block and cost-effectiveness make wrist blocks highly advantageous in diverse clinical scenarios.