Median ulnar nerve selective blockage versus brachial plexus blockage in carpal tunnel release surgery
Median ulnar nerve selective blockage versus brachial plexus blockage in carpal tunnel release surgery
Aim: This study aimed to evaluate the feasibility of median ulnar nerve selective blockage vs. brachial plexus blockage in dayprocedures such as carpal tunnel release surgery. We hypothesized that selective median and ulnar blockage is a feasible classicaxillary approach.Material and Methods: This randomized, controlled, double-blind, single-center study included 60 patients. Patients were randomlyallocated to two groups; namely, the plexus blockage group (control) and selective group. Patients in the plexus blockage group wereadministered with 15 ml of local anesthetic for axillary plexus, and in the selective group, 2.5 ml of local anesthetic was applied underUSG guidance. We evaluated of full sensory and motor block.Results: The onset of motor block time was observed to be longer and recovery time was shorter in the selective group than in theplexus blockage group (P
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- 1. Atroshi I, Gummesson C, Johnsson R et al. Prevalence of carpal tunnel syndrome in a general population. JAMA 1999:282:153–8.
- 2. Jarvik JG, Comstock BA, Michel K et al. Surgery versus non-surgical therapy for carpal tunnel syndrome: a randomised parallel-group trial. Lancet 2009;374:1074–81.
- 3. Hadzic A, Arliss J, Kerimoglu B. A comparison of infraclavicular nerve block versus general anesthesia for hand and wrist day case surgeries. Anesthesiology 2004;101:127–32.
- 4. Marhofer P, Harrop-Griffiths W, Kettner SC et al. Fifteen years of ultrasound guidance in regional anesthesia: Part 1. Br J Anaesth 2010;104:538–46.
- 5. Avellanet M, Sala-Blanch X, Rodrigo L et al. Permanent upper trunk plexopathy after interscalene brachial plexus block. J Clin Monit Comput 2016;30:51–54.
- 6. Madison SJ, Humsi J, Loland VJ et al. Ultrasoundguided root/trunk (interscalene) block for hand and forearm anesthesia. Reg Anesth Pain Med 2013;38:226–32.
- 7. Soberón JR, Bhatt NR, Nossaman B et al. Distal peripheral nerve blockade for patients undergoing hand surgery: a pilot study. Hand (NY) 2015;10:197– 204.
- 8. Liebmann O, Price D, Mills C et al. Feasibility of forearm ultrasonography-guided nerve blocks of the radial, ulnar, and median nerves for hand procedures in the emergency department. Ann Emerg Med 2006;48:558–62.
- 9. Zhu W, Zhou R, Chen L et al. The ultrasound-guided selective nerve block in the upper arm: an approach of retaining the motor function in elbow. BMC Anesthesiol 2018;18:143.
- 10. Lam NCK, Charles M, Mercer D et al. Triple-masked, randomized controlled trial comparing ultrasoundguided brachial plexus and distal peripheral nerve block anesthesia for outpatient hand surgery. Anesthesiol Res Pract 2014;324083.
- 11. Dufeu N, Marchand-Maillet F, Atchabahian A et al. Efficacy and safety of ultrasound-guided distal blocks for analgesia without motor blockade after ambulatory hand surgery. J Hand Surg Am 2014;39:737–43.
- 12. Fingerman M. Regional anesthesia for outpatient hand surgery: ultrasound-guided peripheral nerve block march. J Hand Surg 2011;36:3:532–4.
- 13. Macaire P, Singelyn F, Narchi P et al. Ultrasound- or nerve stimulation-guided wrist blocks for carpal tunnel release: a randomized prospective comparative study. Region Anesth Pain Med 2008;33:363–8.
- 14. Fredrickson MJ, Wolstencroft PJ, Chinchanwala S et al. Does motor block related to long-acting brachial plexus block cause patient dissatisfaction after minor wrist and hand surgery? A randomized observerblinded trial. Br J Anesth 2012;109:809–15.
- 15. Williams B.A, Hackett P.J, Li P et al. Pharmacoeconomics of Regional Anesthesia:Implications in Ambulatory Orthopedic Surgery, Hospital Admission, and Early Rehabilitation. Editor: Admir Hadzic. Hadzic’s Textbook of Regional Anesthesia and Acute Pain Management. 2st ed. New York: McGraw-Hill Professional; 2017,1117-38.