Ulnar nerve block (ultrasound-guided)

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Ulnar nerve blocks are an approach for delivering anesthesia to the ulnar nerve territory either as a standalone blockade or combined with brachial plexus, radial or median nerve block.

Indications

  • burns involving tissue in the ulnar nerve territory
  • rescue analgesia for failed brachial plexus block
  • surgical repair of little finger or fifth metacarpal fractures
  • reductions of the fifth metacarpal or metacarpophalangeal joint dislocations
  • incision and drainage of cysts and abscesses.
  • postoperative analgesia

Contraindications

  • cellulitis or abscess in the site of injection
  • known allergy to local anesthetics
  • compartment syndrome

Equipment

  • high-frequency linear ultrasound probe
  • disinfectant agent
  • sterile ultrasound gel
  • sterile probe cover
  • local anesthetic 
  • skin or block needle

Complications

Complications of the ulnar nerve block may include:

  • active infection of the puncture site
  • intravascular injection
  • allergic reaction to anesthetic products
  • direct nerve damage with neuropraxia or neurolysis
  • intramuscular hematoma
  • unsuccessful block
  • local anesthetic systemic toxicity (LAST)