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Ulnar Nerve Block Periprocedural Care

  • Author: Bassem Asaad, MD; Chief Editor: Meda Raghavendra (Raghu), MD  more...
 
Updated: May 27, 2014
 

Equipment

See the list below:

  • ASA standard monitors (especially if conscious sedation will be provided)
  • Pack of sterile towels and sterile gloves
  • Chlorhexidine sticks
  • High-frequency (10-15 MHz) 25-mm probe
  • Tegaderm and ultrasound gel
  • Nerve stimulator (if the stimulation technique will be combined with the ultrasound technique)
  • 25-gauge needle for skin infiltration
  • 5-cm 22-gauge blunt needle
  • Local anesthetic for the block
 
 
Contributor Information and Disclosures
Author

Bassem Asaad, MD Assistant Professor of Clinical Anesthesiology, The School of Medicine at Stony Brook University Medical Center

Bassem Asaad, MD is a member of the following medical societies: International Spine Intervention Society

Disclosure: Nothing to disclose.

Coauthor(s)

Arvind Chandrakantan, MBBS, MD Assistant Professor of Anesthesiology and Pediatrics, Stony Brook University Medical Center

Disclosure: Nothing to disclose.

Chief Editor

Meda Raghavendra (Raghu), MD Associate Professor, Interventional Pain Management, Department of Anesthesiology, Chicago Stritch School of Medicine, Loyola University Medical Center

Meda Raghavendra (Raghu), MD is a member of the following medical societies: American Society of Anesthesiologists, American Society of Regional Anesthesia and Pain Medicine, American Association of Physicians of Indian Origin

Disclosure: Nothing to disclose.

Acknowledgements

Acknowledgments

Medscape Reference thanks James R Verheyden, MD, Consulting Surgeon, Department of Orthopedic Surgery, The Orthopedic and Neurosurgical Center of the Cascades, for assistance with the video contribution to this article.

References
  1. Gray H. Gray’s Anatomy. 36th edition. WB Saunders Co: Philadelphia, PA; 1980. 1100-1101.

  2. Fredrickson MJ, Ting FS, Chinchanwala S, Boland MR. Concomitant infraclavicular plus distal median, radial, and ulnar nerve blockade accelerates upper extremity anaesthesia and improves block consistency compared with infraclavicular block alone. Br J Anaesth. 2011 Aug. 107(2):236-42. [Medline].

  3. Liebmann O, Price D, Mills C, Gardner R, Wang R, Wilson S. 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 Nov. 48(5):558-62. [Medline].

  4. Stone MB, Muresanu M. Ultrasound-guided ulnar nerve block in the management of digital abscess and hand cellulitis. Acad Emerg Med. 2010 Jan. 17(1):E3-4. [Medline].

  5. Gray AT, Schafhalter-Zoppoth I. Ultrasound guidance for ulnar nerve block in the forearm. Reg Anesth Pain Med. 2003 Jul-Aug. 28(4):335-9. [Medline].

  6. Huntoon MA, Burgher AH. Ultrasound-guided permanent implantation of peripheral nerve stimulation (PNS) system for neuropathic pain of the extremities: original cases and outcomes. Pain Med. 2009 Nov. 10(8):1369-77. [Medline].

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Ulnar and median nerve injections one day following collagenase clostridium histolyticum (Xiaflex) injection and prior to performance of a finger extension procedure. Video courtesy of James R Verheyden, MD.
Blocking of the right ulnar nerve above the elbow. The probe is placed to visualize the short axis of the ulnar nerve.
Ultrasound Guided nerve block at the elbow. A. Ulnar nerve, B. Medial epicondyle
Blocking the ulnar nerve above the wrist. The probe is placed to visualize the short axis views of the ulnar nerve and artery.
Ultrasound guided nerve block above the wrist. A. Ulnar artery (lateral) B. Ulnar Nerve (Medial)
 
 
 
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