Effectiveness of wrist block in patients undergoing hand surgery

Background: There are many anesthesia options for hand surgery. Wrist block is a procedure involving median, radial, or ulnar nerve block at the wrist level, which surgeons can perform by themselves prior to the operation and it also reduces costs and hospital stay, but there is scarce literature about its effectiveness among various types of operations. Objective: To evaluate the effectiveness of wrist block at 30 and 120 minutes after injection in patients undergoing hand surgery. Materials and Methods: A retrospective chart review of 23 patients from the Trauma unit of Siriraj Hospital undergoing hand surgery under anatomical-landmark-based wrist block performed by a single plastic surgeon. Results: Wrist block was effective in 17 patients (73.9%). Among the block-failure patients, additional digital nerve block and local anesthesia were given and all patients could then tolerate the operation. At the follow-up examination, no hematoma at the puncture site nor neuroma was found. Conclusion: Wrist block is one of the safest and most effective anesthesia options for various types of hand surgery, but the conventional anatomical-landmark-based technique may be ineffective in some patients due to either anatomical variation or the precision of injection.