Single Injection Infraclavicular vs. Distal Peripheral Nerve Block for Wrist and Hand Surgery

Brachial plexus block is a commonly performed anaesthetic/analgesic technique for elective wrist and hand surgery. Traditionally, long acting local anaesthetic is used which provides 12-15 hours potent postoperative analgesia; however, some patients experience dissatisfaction from the inevitable proximal limb paralysis. The recent availability in the operating room of portable ultrasound equipment has made it very feasible to block, at the level of the forearm, the individual nerves supplying the wrist and hand. This enables the provision of potent analgesia but without proximal extremity motor weakness. A potential disadvantage of this approach, however, is that the duration of blockade may be shorter. The 2 approaches are to be compared in a prospective randomised manner with patient satisfaction as the primary outcome.