Can We Perform Distal Nerve Block Instead of Brachial Plexus Nerve Block Under Ultrasound Guidance for Hand Surgery?
OBJECTIVE
Distal nerve blocks are used in the event of unsuccessful blocks as rescue techniques. The primary purpose of this study was to determine the sufficiency for anesthesia of distal nerve block without the need for deep sedation or general anesthesia. The secondary purpose was to compare block performance times, block onset times, and patient and surgeon satisfaction.


METHODS
Patients who underwent hand surgery associated with the innervation area of the radial and median nerves were included in the study. Thirty-four patients who were 18-65 years old and American Society of Anesthesiologists grade I-III and who were scheduled for elective hand surgery under conscious nerve block anesthesia were randomly included in an infraclavicular block group (Group I, n=17) or a radial plus median block group (Group RM, n=17). The block performance time, block onset time, satisfaction of the patient and surgeon, and number of fentanyl administrations were recorded.


RESULTS
The numbers of patients who needed fentanyl administration and conversion to general anesthesia were the same in Group I and Group RM and there was no statistically significant difference (p>0.05). The demographics, surgery times, tourniquet times, block perfomance times, and patient and surgeon satisfaction of the groups were similar and there were no statistically significant differences (p>0.05). There was a statistically significant difference in block onset times between the groups (p<0.05).


CONCLUSIONS
Conscious hand surgery can be performed under distal nerve block anesthesia safely and successfully.
Department of Anesthesiology and Reanimation, Atatürk University School of Medicine, Erzurum, Turkey.
Ilker
I
Ince
Department of Anesthesiology and Reanimation, Atatürk University School of Medicine, Erzurum, Turkey.
Mehmet
M
Aksoy
Department of Anesthesiology and Reanimation, Atatürk University School of Medicine, Erzurum, Turkey.
Mine
M
Celik
Distal nerve block; brachial plexus; median nerve; proximal nerve block; radial nerve