• Reg Anesth Pain Med · Jul 2008

    Randomized Controlled Trial Comparative Study

    Ultrasound- or nerve stimulation-guided wrist blocks for carpal tunnel release: a randomized prospective comparative study.

    • Philippe Macaire, François Singelyn, Patrick Narchi, and Xavier Paqueron.
    • Department of Anesthesiology, Dubai Medical Suites, Dubai Healthcare City, UAE. phmacaire@hotmail.com
    • Reg Anesth Pain Med. 2008 Jul 1;33(4):363-8.

    Background And ObjectivesWe hypothesized that ultrasound-guided wrist blocks may be faster to perform, and may increase success rate, compared with nerve stimulation-guided wrist blocks.MethodsSixty 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.ResultsMedian 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.ConclusionsThis randomized prospective study demonstrates that ultrasound-guided wrist nerve blocks are as efficient as those performed with nerve stimulation.

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