Download Blocks at the Wrist

Blocks at the Wrist
Indication:
 Surgery of the hand, rescue blocks
Position:
 The arm is placed with the palm facing up.
Ulnar Nerve Block at the Wrist
Anatomy:
 The ulnar nerve lies below the flexor carpi ulnaris tendon and medial to the ulnar artery.
Procedure:
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Mark a point 5cm above the wrist crease.
Insert the needle posterior to the flexor carpi ulnaris tendon.
Obtain adduction of the thumb and little finger at < 0.5mA and inject.
Inject 5mL of local anesthetic.
Median Nerve Block at the Wrist
Anatomy:
 The median nerve lies lateral to the palmaris longus tendon and medial to the flexor carpi
radialis tendon.
Procedure:
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Mark a point 5cm proximal to the wrist crease.
Insert the needle just lateral to the palmaris longus tendon.
Obtain flexion of the fingers and wrist at <0.5mA.
Inject 5mL of local anesthetic.
Radial Nerve Block at the Wrist
 No nerve stimulator is necessary for this block.
 Using a 25G 1.5” short bevel needle inject 5mL of local anesthetic solution in a fan
shaped manner proximal to the anatomical snuff box.