Nerve block: ulnar nerve - Revision history

Danbot: Danbot moved page Nerve Block: Ulnar Nerve to Nerve block: ulnar nerve without leaving a redirect: Naming convention: first word capitalized, subsequent words lowercase

2026-03-22T05:33:25Z

Danbot moved page Nerve Block: Ulnar Nerve to Nerve block: ulnar nerve without leaving a redirect: Naming convention: first word capitalized, subsequent words lowercase

← Older revision	Revision as of 05:33, 22 March 2026
(No difference)

Rossdonaldson1 at 21:45, 12 June 2021

2021-06-12T21:45:55Z

← Older revision		Revision as of 21:45, 12 June 2021
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	==Background==		==Background==
	[[File:Nerves of the left upper extremity.gif\|thumb\|Nerves of the left upper extremity.]]		[[File:Nerves of the left upper extremity.gif\|thumb\|Nerves of the left upper extremity.]]
			[[File:Gray421.png\|thumb\|Transverse section across distal ends of radius and ulna.]]
	*Ulnar nerve block is a quick, safe, and effective means of pain reduction for hand injuries, including reduction of [[Boxer's Fracture]]<ref>Ünlüer, EE. Ultrasound-guided Ulnar Nerve Block For Boxers Fractures. Am.J.Emerg.Med. 2016;34(8):1726.</ref>		*Ulnar nerve block is a quick, safe, and effective means of pain reduction for hand injuries, including reduction of [[Boxer's Fracture]]<ref>Ünlüer, EE. Ultrasound-guided Ulnar Nerve Block For Boxers Fractures. Am.J.Emerg.Med. 2016;34(8):1726.</ref>

Rossdonaldson1 at 21:44, 12 June 2021

2021-06-12T21:44:22Z

← Older revision		Revision as of 21:44, 12 June 2021
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	==Background==		==Background==
			[[File:Nerves of the left upper extremity.gif\|thumb\|Nerves of the left upper extremity.]]
	*Ulnar nerve block is a quick, safe, and effective means of pain reduction for hand injuries, including reduction of [[Boxer's Fracture]]<ref>Ünlüer, EE. Ultrasound-guided Ulnar Nerve Block For Boxers Fractures. Am.J.Emerg.Med. 2016;34(8):1726.</ref>		*Ulnar nerve block is a quick, safe, and effective means of pain reduction for hand injuries, including reduction of [[Boxer's Fracture]]<ref>Ünlüer, EE. Ultrasound-guided Ulnar Nerve Block For Boxers Fractures. Am.J.Emerg.Med. 2016;34(8):1726.</ref>

Devin Smith at 22:45, 19 February 2017

2017-02-19T22:45:59Z

← Older revision		Revision as of 22:45, 19 February 2017
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	*Inject approximately 3-5 mL of local anesthetic		*Inject approximately 3-5 mL of local anesthetic

	=Complications=		==Complications==
	*Inadvertent intravascular injection		*Inadvertent intravascular injection
	*Infection		*Infection

Devin Smith: Added external link to sonoguide for U/S guided nerve block

2017-02-19T22:44:03Z

Added external link to sonoguide for U/S guided nerve block

← Older revision		Revision as of 22:44, 19 February 2017
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	*In a sterile fashion, apply a superficial small wheel of local anesthetic to the area proximal to the medial humeral epicondyle		*In a sterile fashion, apply a superficial small wheel of local anesthetic to the area proximal to the medial humeral epicondyle
	===Non-Ultrasound Guided Technique===		===Non-Ultrasound Guided Technique===
	* Injection site should be chosen approximately 2-3 cm proximal to the sulcus ulnaris groove		*Injection site should be chosen approximately 2-3 cm proximal to the sulcus ulnaris groove
	** This is done as the ulnar nerve is relatively fixed in the tight groove and it is important to minimize risk of direct nerve trauma and neurapraxia due to pressure build up		**This is done as the ulnar nerve is relatively fixed in the tight groove and it is important to minimize risk of direct nerve trauma and neurapraxia due to pressure build up
	* Direct the needle cephalad at 45 degrees<ref>McCahon, RA et al. Peripheral nerve block at the elbow and wrist. Contin Educ Anaesth Crit Care Pain (2007) 7 (2): 42-44.</ref>		*Direct the needle cephalad at 45 degrees<ref>McCahon, RA et al. Peripheral nerve block at the elbow and wrist. Contin Educ Anaesth Crit Care Pain (2007) 7 (2): 42-44.</ref>
	~~===Ultrasound Guided Technique===~~		*Aspirate prior to injection to rule out intravascular placement
			*Discontinue and reposition should the patient report shooting "electrical" pains or numbness prior to injection
			*Inject approximately 3-5 mL of local anesthetic

	=Complications=		=Complications=
	*Inadvertent intravascular injection		*Inadvertent intravascular injection
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	*[[Nerve blocks (main)]]		*[[Nerve blocks (main)]]
	*[[Local anesthetic systemic toxicity]]		*[[Local anesthetic systemic toxicity]]

			==External Links==
			*[http://www.sonoguide.com/ulnar_plexus_block.html SonoGuide]

	==References==		==References==

Devin Smith at 22:37, 19 February 2017

2017-02-19T22:37:33Z

← Older revision		Revision as of 22:37, 19 February 2017
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	*In a sterile fashion, apply a superficial small wheel of local anesthetic to the area proximal to the medial humeral epicondyle		*In a sterile fashion, apply a superficial small wheel of local anesthetic to the area proximal to the medial humeral epicondyle
	===Non-Ultrasound Guided Technique===		===Non-Ultrasound Guided Technique===
			* Injection site should be chosen approximately 2-3 cm proximal to the sulcus ulnaris groove
			** This is done as the ulnar nerve is relatively fixed in the tight groove and it is important to minimize risk of direct nerve trauma and neurapraxia due to pressure build up
			* Direct the needle cephalad at 45 degrees<ref>McCahon, RA et al. Peripheral nerve block at the elbow and wrist. Contin Educ Anaesth Crit Care Pain (2007) 7 (2): 42-44.</ref>
	===Ultrasound Guided Technique===		===Ultrasound Guided Technique===
	=Complications=		=Complications=

Devin Smith at 22:29, 19 February 2017

2017-02-19T22:29:38Z

← Older revision		Revision as of 22:29, 19 February 2017
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	=Background=		==Background==
	*Ulnar nerve block is a quick, safe, and effective means of pain reduction for hand injuries, including reduction of [[Boxer's Fracture]]<ref>Ünlüer, EE. Ultrasound-guided Ulnar Nerve Block For Boxers Fractures. Am.J.Emerg.Med. 2016;34(8):1726.</ref>		*Ulnar nerve block is a quick, safe, and effective means of pain reduction for hand injuries, including reduction of [[Boxer's Fracture]]<ref>Ünlüer, EE. Ultrasound-guided Ulnar Nerve Block For Boxers Fractures. Am.J.Emerg.Med. 2016;34(8):1726.</ref>

	=Indications=		==Indications==
	*[[Boxer's Fracture]]		*[[Boxer's Fracture]]
	*[[Burns\|Hand Burns]]		*[[Burns\|Hand Burns]]
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	*Need for pain control or to perform painful procedure in distribution of ulnar nerve		*Need for pain control or to perform painful procedure in distribution of ulnar nerve

	=Contraindications=		==Contraindications==
	*Infection overlying injection site		*Infection overlying injection site

	=Equipment Needed=		==Equipment Needed==
	*10 cc Syringe with a 27 Gauge Needle		*10 cc Syringe with a 27 Gauge Needle
	*Blunt fill needle (to draw up anesthetic)		*Blunt fill needle (to draw up anesthetic)
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	*Linear Ultrasound Probe		*Linear Ultrasound Probe

	=Procedure=		==Wrist Block Procedure==
	[[File:Blind_Ulnar_Nerve_Block.jpg\|thumb\|Ulnar Nerve Block at the Wrist]]		[[File:Blind_Ulnar_Nerve_Block.jpg\|thumb\|Ulnar Nerve Block at the Wrist]]
	[[File:Ultrasound_Ulnar_Nerve.png\|thumb\|Ulnar Nerve at the Distal Wrist]]		[[File:Ultrasound_Ulnar_Nerve.png\|thumb\|Ulnar Nerve at the Distal Wrist]]
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	*In a sterile fashion, apply a small wheel of local anesthetic to the area immediately medial to tendon of the Flexor Carpi Ulnaris and approximately 2 cm proximal to the wrist crease.		*In a sterile fashion, apply a small wheel of local anesthetic to the area immediately medial to tendon of the Flexor Carpi Ulnaris and approximately 2 cm proximal to the wrist crease.
	*The ulnar nerve should be immediately deep to the Flexor Carpi Ulnaris Tendon		*The ulnar nerve should be immediately deep to the Flexor Carpi Ulnaris Tendon
	~~==Wrist Block==~~
	===Non-Ultrasound Guided Technique===		===Non-Ultrasound Guided Technique===
	*Direct the Needle radially, deep to the Flexor Carpi Ulnaris		*Direct the Needle radially, deep to the Flexor Carpi Ulnaris
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	*Discontinue and reposition should the patient report shooting "electrical" pains or numbness prior to injection		*Discontinue and reposition should the patient report shooting "electrical" pains or numbness prior to injection
	*Inject approximately 5 mL of local anesthetic in the area immediately surrounding the Ulnar Nerve		*Inject approximately 5 mL of local anesthetic in the area immediately surrounding the Ulnar Nerve
	==Elbow Block==		==Elbow Block Procedure==
			[[File:Ulnar_Elbow.jpg\|thumb\|Ulnar Nerve Path at Elbow]]
			*Obtain informed consent
			**Patient should be made aware that they will lose both sensory and motor function of the ulnar distribution until the anesthetic wears off
			*Place the patient's extremity in the supinated position with elbow flexed between 45 & 90 degrees
			*Cleanse the skin with chosen antiseptic
			*Create a sterile field using sterile drape
			*In a sterile fashion, apply a superficial small wheel of local anesthetic to the area proximal to the medial humeral epicondyle
	===Non-Ultrasound Guided Technique===		===Non-Ultrasound Guided Technique===

	===Ultrasound Guided Technique===		===Ultrasound Guided Technique===
	=Complications=		=Complications=
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	*Neurapraxia		*Neurapraxia

	=See Also=		==See Also==
	*[[Nerve blocks (main)]]		*[[Nerve blocks (main)]]
	*[[Local anesthetic systemic toxicity]]		*[[Local anesthetic systemic toxicity]]

	=References=		==References==
	<references/>		<references/>

	[[Category:Procedures]]		[[Category:Procedures]]
	[[Category:Ultrasound]]		[[Category:Ultrasound]]

Devin Smith at 21:47, 19 February 2017

2017-02-19T21:47:30Z

← Older revision		Revision as of 21:47, 19 February 2017
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	==Background==		=Background=
	*Ulnar nerve block is a quick, safe, and effective means of pain reduction for hand injuries, including reduction of [[Boxer's Fracture]]<ref>Ünlüer, EE. Ultrasound-guided Ulnar Nerve Block For Boxers Fractures. Am.J.Emerg.Med. 2016;34(8):1726.</ref>		*Ulnar nerve block is a quick, safe, and effective means of pain reduction for hand injuries, including reduction of [[Boxer's Fracture]]<ref>Ünlüer, EE. Ultrasound-guided Ulnar Nerve Block For Boxers Fractures. Am.J.Emerg.Med. 2016;34(8):1726.</ref>

	==Indications==		=Indications=
	*[[Boxer's Fracture]]		*[[Boxer's Fracture]]
	*[[Burns\|Hand Burns]]		*[[Burns\|Hand Burns]]
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	*Need for pain control or to perform painful procedure in distribution of ulnar nerve		*Need for pain control or to perform painful procedure in distribution of ulnar nerve

	==Contraindications==		=Contraindications=
	*Infection overlying injection site		*Infection overlying injection site

	==Equipment Needed==		=Equipment Needed=
	*10 cc Syringe with a 27 Gauge Needle		*10 cc Syringe with a 27 Gauge Needle
	*Blunt fill needle (to draw up anesthetic)		*Blunt fill needle (to draw up anesthetic)
Line 20:		Line 20:
	*Linear Ultrasound Probe		*Linear Ultrasound Probe

	==Procedure==		=Procedure=
	[[File:Blind_Ulnar_Nerve_Block.jpg\|thumb\|Ulnar Nerve Block at the Wrist]]		[[File:Blind_Ulnar_Nerve_Block.jpg\|thumb\|Ulnar Nerve Block at the Wrist]]
	[[File:Ultrasound_Ulnar_Nerve.png\|thumb\|Ulnar Nerve at the Distal Wrist]]		[[File:Ultrasound_Ulnar_Nerve.png\|thumb\|Ulnar Nerve at the Distal Wrist]]
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	*In a sterile fashion, apply a small wheel of local anesthetic to the area immediately medial to tendon of the Flexor Carpi Ulnaris and approximately 2 cm proximal to the wrist crease.		*In a sterile fashion, apply a small wheel of local anesthetic to the area immediately medial to tendon of the Flexor Carpi Ulnaris and approximately 2 cm proximal to the wrist crease.
	*The ulnar nerve should be immediately deep to the Flexor Carpi Ulnaris Tendon		*The ulnar nerve should be immediately deep to the Flexor Carpi Ulnaris Tendon
			==Wrist Block==
	===Non-Ultrasound Guided Technique===		===Non-Ultrasound Guided Technique===
	*Direct the Needle radially, deep to the Flexor Carpi Ulnaris		*Direct the Needle radially, deep to the Flexor Carpi Ulnaris
Line 48:		Line 48:
	*Discontinue and reposition should the patient report shooting "electrical" pains or numbness prior to injection		*Discontinue and reposition should the patient report shooting "electrical" pains or numbness prior to injection
	*Inject approximately 5 mL of local anesthetic in the area immediately surrounding the Ulnar Nerve		*Inject approximately 5 mL of local anesthetic in the area immediately surrounding the Ulnar Nerve
			==Elbow Block==
	==Complications==		===Non-Ultrasound Guided Technique===
			===Ultrasound Guided Technique===
			=Complications=
	*Inadvertent intravascular injection		*Inadvertent intravascular injection
	*Infection		*Infection
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	*Neurapraxia		*Neurapraxia

	==See Also==		=See Also=
	*[[Nerve blocks (main)]]		*[[Nerve blocks (main)]]
	*[[Local anesthetic systemic toxicity]]		*[[Local anesthetic systemic toxicity]]

	==References==		=References=
	<references/>		<references/>

	[[Category:Procedures]]		[[Category:Procedures]]
	[[Category:Ultrasound]]		[[Category:Ultrasound]]

Mholtz at 18:08, 3 February 2017

2017-02-03T18:08:59Z

← Older revision		Revision as of 18:08, 3 February 2017
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	==Background==		==Background==
	* ~~This has been found to be~~ a quick, safe, and effective means of pain reduction for hand injuries, including reduction of [[Boxer's Fracture]]. <ref> Ünlüer, EE. Ultrasound-guided Ulnar Nerve Block For Boxers Fractures. Am. J. Emerg. Med. 2016; 34 (8): 1726. </ref>		*Ulnar nerve block is a quick, safe, and effective means of pain reduction for hand injuries, including reduction of [[Boxer's Fracture]]<ref>Ünlüer, EE. Ultrasound-guided Ulnar Nerve Block For Boxers Fractures. Am.J.Emerg.Med. 2016;34(8):1726.</ref>

	==Indications==		==Indications==
	* [[Boxer's Fracture]]		*[[Boxer's Fracture]]
	* [[Burns\|Hand Burns]]		*[[Burns\|Hand Burns]]
	* [[Hand and finger tendon injuries\|Complex Hand Injury]]		*[[Hand and finger tendon injuries\|Complex Hand Injury]]
			*Need for pain control or to perform painful procedure in distribution of ulnar nerve

	==Contraindications==		==Contraindications==
	* ~~Overlying~~ site ~~infection~~		*Infection overlying injection site
	* Injury requiring close neurologic observation (e.g. [[Compartment Syndrome]])

	==Equipment Needed==		==Equipment Needed==
	* 10 cc Syringe with a 27 Gauge Needle		*10 cc Syringe with a 27 Gauge Needle
	* ~~Spare 18 Gauge Needle~~ (to draw up anesthetic)		*Blunt fill needle (to draw up anesthetic)
	* Local Anesthetic (e.g. [[Lidocaine]] vs [[Bupivacaine]])		*Local Anesthetic (e.g. [[Lidocaine]] or [[Bupivacaine]])
	* Antiseptic (e.g. Chlorhexidine, Betadine~~, Rubbing Alcohol~~)		*Antiseptic (e.g. Chlorhexidine, Betadine)
	* Sterile Gloves		*Sterile Gloves
	* Sterile Drape		*Sterile Drape and sterile ultrasound probe cover
	* Linear Ultrasound Probe ~~(for ultrasound guided procedure)~~		*Linear Ultrasound Probe
	* Sterile Ultrasound Prove Cover (for ultrasound guided procedure)

	==Procedure==		==Procedure==
	* Discuss the ~~procedure with~~ the ~~patient regarding desired effects and potential complications~~		[[File:Blind_Ulnar_Nerve_Block.jpg\|thumb\|Ulnar Nerve Block at the Wrist]]
	* ~~They~~ should be made aware that they will lose both sensory and motor function of the ulnar distribution until the anesthetic wears off		[[File:Ultrasound_Ulnar_Nerve.png\|thumb\|Ulnar Nerve at the Distal Wrist]]
	* Place the patient's extremity in the supinated position		[[File:Ulnar_Nerve_US_Probe.png\|thumb\|Following the Ulnar Nerve Distally]]
	* Cleanse the skin with chosen antiseptic
	* Create a sterile field using ~~your~~ sterile drape		*Obtain informed consent
	* In a sterile fashion, apply a small wheel of local anesthetic to the area immediately ~~ulnar~~ to tendon of the Flexor Carpi Ulnaris approximately 2 cm proximal to the wrist crease.		**Patient should be made aware that they will lose both sensory and motor function of the ulnar distribution until the anesthetic wears off
	* The ulnar nerve should be immediately deep to the Flexor Carpi Ulnaris Tendon		*Place the patient's extremity in the supinated position
			*Cleanse the skin with chosen antiseptic
			*Create a sterile field using sterile drape
			*In a sterile fashion, apply a small wheel of local anesthetic to the area immediately medial to tendon of the Flexor Carpi Ulnaris and approximately 2 cm proximal to the wrist crease.
			*The ulnar nerve should be immediately deep to the Flexor Carpi Ulnaris Tendon

	===Non-Ultrasound Guided Technique===		===Non-Ultrasound Guided Technique===
	~~[[File:Blind_Ulnar_Nerve_Block.jpg\|thumb\|Ulnar Nerve Block at the Wrist]]~~		*Direct the Needle radially, deep to the Flexor Carpi Ulnaris
	* Direct the Needle radially, deep to the Flexor Carpi Ulnaris		*The ulnar nerve is ulnar in relation to the ulnar artery; even still, it is important to aspirate prior to injecting anesthetic to rule out intra-arterial placement
	* The ulnar nerve is ulnar in relation to the ulnar artery; even still, it is important to aspirate prior to injecting anesthetic to rule out intra-arterial placement		*Discontinue and reposition should the patient report shooting "electrical" pains or numbness prior to injection
	* Discontinue and reposition should the patient report shooting "electrical" pains or numbness prior to injection		*Inject approximately 5 mL of local anesthetic
	* Inject approximately 5 mL of local anesthetic

	===Ultrasound Guided Technique===		===Ultrasound Guided Technique===
	~~[[File:Ultrasound_Ulnar_Nerve.png\|thumb\|Ulnar Nerve at the Distal Wrist]]~~		*Have a partner help place the Linear Ultrasound Probe into the Sterile Probe Cover
	~~[[File:Ulnar_Nerve_US_Probe.png\|thumb\|Following the Ulnar Nerve Distally]]~~		*Starting mid forearm of the volar aspect in a transverse plane, locate the Ulnar Nerve
	* Have a partner help place the Linear Ultrasound Probe into the Sterile Probe Cover		*Sliding Distally, the Ulnar Nerve and Artery should separate from each other
	* Starting mid forearm of the volar aspect in a transverse plane, locate the Ulnar Nerve		*Injection site is generally approximately 2 cm proximal to the wrist crease.
	* Sliding Distally, the Ulnar Nerve and Artery should separate from each other		*In plane, visualize the needle on the Ultrasound monitor as you advance towards the Ulnar Nerve.
	* Injection site is generally approximately 2 cm proximal to the wrist crease.		*Make sure to aspirate prior to injecting to rule out vascular penetration (low risk given ultrasound guidance)
	* In plane, visualize the needle on the Ultrasound monitor as you advance towards the Ulnar Nerve.		*Discontinue and reposition should the patient report shooting "electrical" pains or numbness prior to injection
	* Make sure to aspirate prior to injecting to rule out vascular penetration (low risk given ultrasound guidance)		*Inject approximately 5 mL of local anesthetic in the area immediately surrounding the Ulnar Nerve
	* Discontinue and reposition should the patient report shooting "electrical" pains or numbness prior to injection
	* Inject approximately 5 mL of local anesthetic in the area immediately surrounding the Ulnar Nerve

	==Complications==		==Complications==
	* Inadvertent intravascular injection		*Inadvertent intravascular injection
	* Infection		*Infection
	* Bleeding/hematoma		*Bleeding/hematoma
	* Neurapraxia		*Neurapraxia

	==See Also==		==See Also==
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	[[Category:Procedures]]		[[Category:Procedures]]
			[[Category:Ultrasound]]

Zipdoc at 05:58, 29 January 2017

2017-01-29T05:58:39Z

← Older revision		Revision as of 05:58, 29 January 2017
Line 61:		Line 61:
	==References==		==References==
	<references/>		<references/>

			[[Category:Procedures]]