Blocks at the wrist using nerve stimulation for ambulatory hand surgery

One hundred and fifty-five patients were included in this prospective, open, multicenter study to examine the use of nerve stimulation to locate the median and ulnar nerves in ambulatory hand surgery. A sensory response was obtained in 65% of cases and a motor response in 65% with median nerve: the failure to elicit a motor response during median nerve stimulation was related to a higher failure rate of blocks (P = 0.041). A sensory response was reported in 63% and a motor response in 70% of the cases concerning the ulnar blocks: a sensory response was associated with greater success in the ulnar nerve (P = 0.01), while fourth and fifth fingers flexion increased the likelihood of failure (P = 0.075). This technique does not impair the organization of the surgical theatre (4 ± 3 min, mean ± S.D. block performance time) and 96% of patients were satisfied with the technique.