Ultrasound- or Nerve Stimulation-Guided Wrist Blocks for Carpal Tunnel Release: A Randomized Prospective Comparative Study

Macaire, Philippe; Singelyn, François; Narchi, P.; Paqueron, Xavier

doi:10.1016/j.rapm.2008.01.004

Cited by 20 publications

(29 citation statements)

References 17 publications

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“…A total of 508 articles were rejected for the following reasons: 448 did not evaluate ultrasound-guided nerve blocks in surgical procedures, 30 were not RCTs, 24 did not compare ultrasound alone versus control, 5 did not assess upper or lower extremity single-shot nerve blocks, and one did not assess surgical success rate. Table 1 provides a detailed overview of the studies included in the analysis [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. Fig.…”

Section: Resultsmentioning

confidence: 99%

Analgesic efficacy of ultrasound-guided regional anesthesia: a meta-analysis

Gelfand¹,

Ouanes²,

Lesley³

et al. 2011

Journal of Clinical Anesthesia

111

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Section: Resultsmentioning

confidence: 99%

Analgesic efficacy of ultrasound-guided regional anesthesia: a meta-analysis

Gelfand¹,

Ouanes²,

Lesley³

et al. 2011

Journal of Clinical Anesthesia

111

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“…Of the 19 studies comparing US against other nerve location methods, 15 demonstrated significant benefit with US, whereas only 1 study favored PNS (Table 1). Commonly identified benefits of US included surrogates of block performance such as faster block performance time 4,6,8,10,13,14,16,18,20 and reduced number of needle passes 2,7,15 and surrogates of better quality block including faster sensory onset time 3,4,8,9,12Y14,16,20 and greater block success. 5,8,9,12Y14,16,20 It should be noted, however, that of the 8 studies that found faster block performance with US, 4 studies 6,13,16,20 did not include the US scan time required before needle insertion.…”

Section: Discussionmentioning

confidence: 99%

Evidence Basis for the Use of Ultrasound for Upper-Extremity Blocks

McCartney

Lin

Shastri

2010

Regional Anesthesia and Pain Medicine

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This article qualitatively assesses and summarizes randomized, controlled studies regarding benefits of ultrasound (US) for brachial plexus block and also examines those studies that have compared different brachial plexus block techniques using US.Studies were identified by a search of PUBMED and EMBASE databases using the MeSH terms anesthetic techniques, brachial plexus, and ultrasound. Included studies were limited to randomized trials that compared a US technique with another accepted method of performing brachial plexus block or those studies that compared 2 different US-guided techniques. Studies were further classified according to methodological quality using accepted methods. Quality scores were compared using Mann-Whitney U test, and significance assumed at P < 0.05.Twenty-five studies met inclusion criteria, with 19 studies comparing US techniques with other nerve location methods and 6 studies comparing different US techniques. Of the former, there was convincing evidence to support the use of US, with 15 of 19 studies demonstrating improved outcomes compared with existing techniques.Ultrasound provides significant advantages when performing brachial plexus block including faster sensory block onset and greater block success.

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“…48 The only randomized controlled trial evaluating whether ultrasound or nerve stimulation is superior for wrist block performance in patients undergoing carpal tunnel surgery did not reveal any differences in success rate, but showed a shorter block performance time in the ultrasound group, whereas the nerve stimulation group had a faster onset time of complete sensory block. 49 …”

Section: Elbow Wrist and Digitalmentioning

confidence: 99%

Outpatient Regional Anesthesia For Upper Extremity Surgery Update (2005 to Present) Distal to Shoulder

Maga

Cooper

Gebhard

2012

International Anesthesiology Clinics

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Multiple different approaches to the brachial plexus are available for the regional anesthesiologist to provide successful anesthesia and analgesia for ambulatory surgery of the upper extremity. Although supraclavicular and infraclavicular blocks are faster to perform than axillary blocks, the operator needs to keep in mind that blocks performed around the clavicle carry the risk for specific side effects and complications, no matter whether ultrasound or nerve stimulation is the chosen modality for neurolocation. Owing to the ambulatory nature of the planned surgical intervention, even significant side effects may not become clinically symptomatic until the patient is discharged from the facility. For example, due to pneumothorax risks, axillary or mid-humeral blocks remain the most logical approaches for ambulatory surgical procedures at and below the elbow, while reserving infra-clavicularor supraclavicular approaches for surgery from the proximal humerus to above the elbow. Smaller interventions such as carpal tunnel release or trigger finger release can be performed under elbow, wrist, or digital blocks. The regional anesthesiologist should strive to develop a tailored plan for each individual case to provide the most effective and safest nerve block technique for their patients.

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Ultrasound- or Nerve Stimulation-Guided Wrist Blocks for Carpal Tunnel Release: A Randomized Prospective Comparative Study

Abstract: This randomized prospective study demonstrates that ultrasound-guided wrist nerve blocks are as efficient as those performed with nerve stimulation.

Cited by 20 publications

References 17 publications

Analgesic efficacy of ultrasound-guided regional anesthesia: a meta-analysis

Analgesic efficacy of ultrasound-guided regional anesthesia: a meta-analysis

Evidence Basis for the Use of Ultrasound for Upper-Extremity Blocks

Outpatient Regional Anesthesia For Upper Extremity Surgery Update (2005 to Present) Distal to Shoulder

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