What approach do you usually perform for a carpal tunnel surgery?

 

A) Distal blocks (forearm)

B) Axillary

C) Supraclavicular

D) Infraclavicular

 

 

Solution:

 

The block of the distal nerves of the upper limb is very useful for hand and forearm surgery. However,  in many cases  the block has to be more proximally because of the concurrent use of a tourniquet.  When performing only a distal block (ulnar, median or radial) for a tunnel carpal surgery, a local anaesthetic injection subcutaneously is required to block the other sensitive branches that innervate the wrist (See the nerve distribution in the picture).

 

 

 

 

 

 

 

 

 

 

 

 

 

All the answers are correct, and you have to choose the best technique for each patient. Anyway, when feasible use a regional technique (preferably ultrasound guided) to get the best results. You will get a superior outcome compared to general anaesthesia (improve analgesia, discharge time and cardiovascular stability).

QUESTIONS & ANSWERS... SOLUTION 1

Source: ARYDOL