Peripheral Nerve Blocks of the Distal Upper Extremity

Sayeh Hamzehzadeh, M.D.
Resident Physician

E. David Bravos M.D.
Assistant Professor

Department of Anesthesiology and Critical Care Medicine
Johns Hopkins Hospital
School of Medicine, Johns Hopkins University
Baltimore, MD

Introduction - TOP

This review is devoted to peripheral nerve blocks of the distal upper extremity, specifically, those of the median, radial and ulnar nerves. These blocks are fairly simple to perform even by a beginner to produce anesthesia or analgesia for surgery of the forearm, wrist and hand. They may be done when blockade of the entire brachial plexus is not necessary or as a “rescue” block with an incomplete brachial plexus block. Traditionally, these blocks have been performed at the level of the elbow and wrist using surface landmarks with nerve stimulation or paresthesia techniques.1,2, More recently, ultrasound has been used to block the nerves at several different points between the elbow and wrist.3

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