Ulnar Nerve Block for Procedural Anesthesia - Wrist Versus Palm

Hand Surgery Clinical Trial

Official title:

Ulnar Nerve Block for Procedural Anesthesia - Wrist Versus Palm

Clinical Trial Details — Status: Terminated

Administrative data

• NCT number: NCT00827658
• Other study ID #: McMaster 08-053
• Status: Terminated
• Phase: N/A
• Start date: February 2008
• Est. completion date: July 2009

Study information

• Verified date: May 2018
• Source: McMaster University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial 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.

Recruitment information / eligibility

• Status: Terminated
• Enrollment: 127
• Est. completion date: July 2009
• Est. primary completion date: July 2009
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years and older

Eligibility

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

Related Conditions & MeSH terms

• Hand Surgery

Intervention

Procedure:
• Volar 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)
• Hypothenar 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)

Locations

Country	Name	City	State
Canada	Hamilton General Hospital	Hamilton	Ontario

Sponsors (2)

Lead Sponsor	Collaborator
Hamilton Health Sciences Corporation	McMaster University

Country where clinical trial is conducted

Canada, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Primary outcome is efficacy of sensory anesthesia and analgesia		15-45 minutes
Secondary	Secondary outcome is patient perceived discomfort with block		15-45 Minutes