JOURNAL ARTICLE
RANDOMIZED CONTROLLED TRIAL

Forearm ultrasound-guided nerve blocks vs landmark-based wrist blocks for hand anesthesia in healthy volunteers

Aparajita Sohoni, Arun Nagdev, Sukhjit Takhar, Michael Stone
American Journal of Emergency Medicine 2016, 34 (4): 730-4
26920669

OBJECTIVE: Although ultrasound-guided regional nerve blocks have become more commonplace in the emergency department, there is no evidence to suggest that they are more effective than traditional landmark-based wrist blocks for hand anesthesia. We hypothesized that ultrasound-guided forearm nerve blocks would provide superior analgesia as compared with conventional landmark-based wrist blocks.

METHODS: Eighteen paired nerve injections were performed by an experienced operator on 12 healthy volunteers. Each subject's right arm was assigned to receive either an ultrasound-guided forearm block with a saline placebo wrist block or a traditional landmark-based wrist block with a saline placebo ultrasound-guided forearm block. The subject's left arm then received the alternate approach. All blocks were performed with 3 mL of 1% lidocaine. We evaluated sensory block to pinprick. Secondary outcome variables included pain associated with injection, participant's subjective assessment of block effectiveness, and presence of any complications.

RESULTS: At 15 minutes postinjection, 14 of 18 (78%; 95% confidence interval [CI], 59%-97%) ultrasound-guided forearm blocks were successful, as opposed to 10 of 18 (56%; 95% CI, 33%-79%) anatomic wrist blocks. The ultrasound-guided forearm blocks had a 22% (95% CI, 2%-42%; P=.032) higher rate of success than the wrist blocks. The ultrasound-guided forearm block was subjectively felt to be denser by 12 of 18 (67%) subjects (P=.0034)).

CONCLUSIONS: Ultrasound-guided forearm nerve blocks performed by an experienced operator result in more effective hand anesthesia than traditional anatomic landmark-based wrist blocks.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Trending Papers

Remove bar
Read by QxMD icon Read
26920669
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"