| ORIGINAL ARTICLE |
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| Year : 2014 | Volume
: 8
| Issue : 5 | Page : 25-28 |
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A cadaveric study comparing the three approaches for ulnar nerve block at wrist
Rohit Varshney1, Nidhi Sharma2, Shraddha Malik3, Sunny Malik4
1 Department of Anesthesia, Teerthanker Mahaveer Medical College, Moradabad, Uttar Pradesh
2 Department of Anatomy, Teerthanker Mahaveer Medical College, Moradabad, Uttar Pradesh
3 Department of Anesthesia, Max Super Speciality Hospital, Saket, New Delhi
4 Department of Anesthesia, Rajiv Gandhi Cancer Hospital Institute and Research Centre, Rohini, New Delhi
Correspondence Address:
Dr. Rohit Varshney
Department of Anesthesia, Teerthankar Mahaveer Medical College, Delhi Road, Moradabad - 244 001, Uttar Pradesh
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/1658-354X.144064
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Background: Ulnar nerve blockade as a component of wrist block is a promising technique for adequate anesthesia and analgesia for different surgeries of the hand. Due to anatomical variations in the location of ulnar nerve under the flexor carpi ulnaris (FCU) a technique with good results and minimal complications are required. Aim: The aim of the following study is to compare the three techniques (volar, transtendinous volar [TTV] and ulnar) for ulnar nerve block at the wrist in human cadaveric wrists. Materials and Methods: Our study was conducted using 40 cadaver wrists. After inserting standard hypodermic needles by three techniques for ulnar nerve blockade at the wrist, a detailed dissection of FCU was done. The mean distance from the tip of the needle to ulnar artery/nerve and number of instances in which the ulnar artery/nerve pierced were observed. Results: Inter-group statistical significance was observed in measurement of the mean distance (mm) from the tip of the needle to the ulnar artery (volar [0.92 ± 0.11], TTV [3.96 ± 0.14] and ulnar [7.14 ± 0.08] approaches) and ulnar nerve (volar/TTV/ulnar approaches were 0.71 ± 0.12/3.61 ± 0.10/6.31 ± 0.49, respectively) (P = 0.001). Inadvertent intra-arterial/intraneural injections was seen with volar approach in 14 (35%) and 16 (40%) of the cadaveric wrists respectively, statistically significant with transtendinous and ulnar techniques of ulnar nerve block. Conclusion: TTV approach could be a better technique of choice for ulnar nerve blockade at the wrist because of its ease to practice, safer profile and minimum chances of inadvertent intra-arterial/intraneural injection with adequate anesthesia/analgesia. |
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