Ulnar Nerve Block for Procedural Anesthesia - Wrist Versus Palm

Status

Terminated

Phases

Study type

Interventional

Source

ClinicalTrials.gov

Registry ID

NCT00827658

Enrollment

127

Registered

2009-01-23

Start date

2008-02-29

Completion date

2009-07-31

Last updated

2018-05-14

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Hand Surgery

Keywords

anesthesia, local, ulnar nerve, hand, surgery, plastic, blinded, randomized, prospective, local anesthesia, volar wrist block, hypothenar palm block, hand surgery

Brief summary

Ulnar nerve blockade is necessary for sensory anesthesia and analgesia in the hand during minor procedures. The course of the ulnar nerve in the forearm, wrist, and hand is predictable and has low variability. However even with known anatomic location and landmarks, ulnar nerve blocks at the wrist frequently are inadequate for procedural anesthesia. The antebrachial fascia at the wrist acts as a barrier to local infiltration. Since the fascia can not be visualized or palpated, it is commonly not penetrated, resulting in an inadequate block. Furthermore at the level of the wrist the ulnar artery lies in close proximity to the nerve and there is potential for arterial puncture while attempting injection for volar wrist block. The palmar ulnar nerve block is an injection distal to the hook of the hamate in the thenar eminence which avoids the ulnar artery and antebrachial fascia. This block has been used successfully for many years in clinical practice but has not been assessed or compared in a research study. The purpose of this study is to assess the validity of using a palmar ulnar nerve block for procedures in the hand as compared to the standard volar wrist ulnar nerve block.

Interventions

PROCEDUREVolar Wrist Block

Injection medial to Flexor Carpi Ulnaris Tendon at volar proximal wrist crease Local Block - total 3 cc injection (1.5 cc 1% plain lidocaine and 1.5 cc of 0.25% bupivicaine)

PROCEDUREHypothenar Palm block

Injection at Hook of the Hamate on Palmar surface Local Block - total 3 cc injection (1.5 cc 1% plain lidocaine and 1.5 cc of 0.25% bupivicaine)

Study design

Allocation

RANDOMIZED

Intervention model

SINGLE_GROUP

Primary purpose

TREATMENT

Masking

SINGLE (Investigator)

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Healthy volunteers

Yes

Inclusion criteria

* any individual who can give informed consent and is scheduled for elective hand procedures by the PI necessitating an Ulnar nerve block of the hand.

Exclusion criteria

* patients unable to give informed consent * patients with previous or ongoing ulnar nerve deficits or neuropathy * patients undergoing Guyon's canal decompression * patients who can not comprehend or cooperate with assessment testing * patients with abnormal two point discrimination (\> 6 mm at the test location) prior to the nerve block

Design outcomes

Primary

Measure	Time frame
Primary outcome is efficacy of sensory anesthesia and analgesia	15-45 minutes

Secondary

Measure	Time frame
Secondary outcome is patient perceived discomfort with block	15-45 Minutes

Countries

Canada

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026