BACKGROUND AND OBJECTIVES: We hypothesized that ultrasound-guided wrist blocks may be faster to perform, and may increase success rate, compared with nerve stimulation-guided wrist blocks. METHODS:Sixty patients undergoing ambulatory endoscopic carpal tunnel release were randomly allocated to receive median and ulnar nerve blocks using either sensory-motor nerve stimulation (n = 30) or ultrasound guidance (n = 30). Four mL of mepivacaine 1.5% was injected around each nerve. Performance time and onset time of complete sensory block were assessed. RESULTS:Median time to perform both median (ultrasound, 55 [48-60] vs. nerve stimulation, 100 [65-150] seconds, P = .002) and ulnar (ultrasound, 57 [50-70] vs. nerve stimulation, 80 [60-105] seconds, P = .02) nerve blocks were significantly shorter in the ultrasound group. Onset time of complete sensory block in the median (ultrasound, 370 [278-459] vs. nerve stimulation, 254 [230-300] seconds, P = .02) and ulnar (ultrasound, 367 [296-420] vs. nerve stimulation, 241 [210-300] seconds, P = .01) nerve areas were shorter in the nerve stimulation group. The success rate was 93% in both groups. CONCLUSIONS: This randomized prospective study demonstrates that ultrasound-guided wrist nerve blocks are as efficient as those performed with nerve stimulation.
RCT Entities:
BACKGROUND AND OBJECTIVES: We hypothesized that ultrasound-guided wrist blocks may be faster to perform, and may increase success rate, compared with nerve stimulation-guided wrist blocks. METHODS: Sixty patients undergoing ambulatory endoscopic carpal tunnel release were randomly allocated to receive median and ulnar nerve blocks using either sensory-motor nerve stimulation (n = 30) or ultrasound guidance (n = 30). Four mL of mepivacaine 1.5% was injected around each nerve. Performance time and onset time of complete sensory block were assessed. RESULTS: Median time to perform both median (ultrasound, 55 [48-60] vs. nerve stimulation, 100 [65-150] seconds, P = .002) and ulnar (ultrasound, 57 [50-70] vs. nerve stimulation, 80 [60-105] seconds, P = .02) nerve blocks were significantly shorter in the ultrasound group. Onset time of complete sensory block in the median (ultrasound, 370 [278-459] vs. nerve stimulation, 254 [230-300] seconds, P = .02) and ulnar (ultrasound, 367 [296-420] vs. nerve stimulation, 241 [210-300] seconds, P = .01) nerve areas were shorter in the nerve stimulation group. The success rate was 93% in both groups. CONCLUSIONS: This randomized prospective study demonstrates that ultrasound-guided wrist nerve blocks are as efficient as those performed with nerve stimulation.
Authors: Joseph M Neal; J C Gerancher; James R Hebl; Brian M Ilfeld; Colin J L McCartney; Carlo D Franco; Quinn H Hogan Journal: Reg Anesth Pain Med Date: 2009 Mar-Apr Impact factor: 6.288
Authors: Nicholas C K Lam; Matthew Charles; Deana Mercer; Codruta Soneru; Jennifer Dillow; Francisco Jaime; Timothy R Petersen; Edward R Mariano Journal: Anesthesiol Res Pract Date: 2014-04-15