Surgeon-administered Ultrasound-guided Peripheral Nerve Blocks in Outpatient Procedures of the Upper Extremity

Jessica Winter, Graham McLeod, Tanis Quaife, Christian Petropolis, Jessica Winter, Graham McLeod, Tanis Quaife, Christian Petropolis

Abstract

Outpatient hand surgery is often performed in the operating room, which can result in prolonged waiting times for patients when operating room resources are limited. Few studies have explored the application of ultrasound-guided nerve blocks in the setting of outpatient hand surgery. Fifty patients were enrolled in this prospective study. Ultrasound-guided peripheral nerve blocks were performed at the level of the elbow and proximal forearm for outpatient hand surgeries. A timer was used to record the time to administer the block and time to affect. A post-procedure survey was administered, which included a numerical analogue scale (0-10) and Likert rating scale questions to characterize the patients' pain experience for receiving the block and pain during the procedure: pain experienced by patients receiving the ultrasound-guided nerve block(s) (0-10), mean: 1.84; pain experienced by patients during a procedure (0-10), mean: 0.56; surgeon satisfaction during the procedure (0-10), mean 9.78. Average time to perform the ultrasound-guided nerve block(s) was 4 minutes 58 seconds; average time from completion of the block to effect reported by patients, 5 minutes 42 seconds; the average time for performing the procedure, 21 minutes 30 seconds. Our study shows that the use of ultrasound to block peripheral nerves of the forearm is effective; <10% of patients required additional local anesthetic. The technique is safe; no complications were reported. The technique is efficient in an outpatient hand surgery setting.

Conflict of interest statement

Disclosure: The authors have no financial interest to declare in relation to the content of this article.

Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.

Figures

Fig. 1.
Fig. 1.
Materials required to perform ultrasound-guided block: iPad, Bluetooth probe, sterile ultrasound gel, and tegaderm.
Fig. 2.
Fig. 2.
Median nerve landmark.
Fig. 3.
Fig. 3.
Ulnar nerve landmark.
Fig. 4.
Fig. 4.
Radial nerve landmark.

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Source: PubMed

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