title: The use of peripheral nerve blocks at the elbow for carpal tunnel release.
abstract: This case report illustrates that median, radial, and ulnar nerve blocks at the elbow provides anesthesia for ambulatory carpal tunnel release surgery. This report discusses 3 patients with medical conditions, including vascular access problems and morbid obesity, which made nerve blocks at the elbow advantageous compared with other anesthetic techniques. Peripheral nerve blocks at the elbow were done before surgery in a block room, so the patients spent less time in the operating room. Nerve blocks at the elbow are effective anesthesia for hand procedures with no patient requiring further local anesthetic injection and opioids for pain or expressing any discomfort during surgery. The blocks are easy to perform and set up quickly, and using long-acting local anesthetics, elbow blocks provide postoperative pain control for approximately 10 hours. The nerve blocks at the elbow facilitate the perioperative process by being done out of the operating room and providing prolonged pain control without the need for opioids, so nausea may be avoided.
authors.affiliation: Department of Anesthesiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. dilger.john@mayo.edu
authors.forename: John A
authors.initials: JA
authors.lastname: Dilger
authors.forename: Robert E
authors.initials: RE
authors.lastname: Wells
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D001993:Bronchodilator Agents / Q000008:administration & dosage; D002349:Carpal Tunnel Syndrome / Q000601:surgery*; D004550:Elbow / Q000294:innervation*; D004837:Epinephrine / Q000008:administration & dosage; D006801:Humans; D008619:Mepivacaine / Q000008:administration & dosage; D008874:Midazolam / Q000008:administration & dosage; D009407:Nerve Block / Q000379:methods*; D010525:Peripheral Nerves / Q000187:drug effects*; D013748:Tetracaine / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D001993:Bronchodilator Agents; D013748:Tetracaine; D008619:Mepivacaine; D008874:Midazolam; D004837:Epinephrine