The use of a selective peripheral median nerve block for pain-free early active motion after hand surgery.

We describe a simple method in which a nearly selective sensory median nerve block is used for early motion exercises. In this method an 18-gauge epidural catheter with 3 side holes in the fine catheter tip is placed proximal to the carpal tunnel. A bolus of 5 mL of 0.25% bupivacaine is injected before a continuous infusion of 3 mL/60 min of 0.125% bupivacaine is started. This method allows a continuous and selective sensory blockade with preservation of motor function and proprioception for early motion after hand surgeries.