[Locoregional anesthesia for endoscopic surgery of the carpal tunnel]

Local anaesthesia for surgical endoscopic release of carpal ligament is obtained with a block of the median nerve associated with subcutaneous infiltration of the areas of entrance and exit of the endoscope. A palmar application of Emla cream makes the needle puncture painless. The accidental puncture of the median nerve, which occurs when the needle is inserted too rapidly, is the only potential complication. It is easily prevented by pushing the needle gently forward and orientating the bevel parallel to the axis of the nerve. The use of a neurostimulator and needle with a blunt tip can be an alternative. We used this technique in more than 1,500 patients. Only one accidental puncture of the nerve due to a technical error occurred.