Forearm Blocks

Peripheral blocks of terminal branches of the brachial plexus (median, radial, and ulnar nerves) can offer benefits in terms of patient disposition.^1,2 These procedures can be used to prevent and treat postoperative pain. Ultrasound-guided nerve blocks of the radial, ulnar, and median nerves are also useful in the emergency department to provide anesthesia for hand procedures.³

Forearm blocks provide sensory anesthesia of the hand and block the intrinsic muscles of the hand. However, the extrinsic muscles (the more proximal branches to the flexors and extensors of the digits) are spared, and therefore some hand motion is possible. Forearm blocks are useful for trigger finger release when active motion is desired and other minor surgical procedures of the hand that do not require a tourniquet. Because forearm blocks anesthetize the proximal palmar and dorsal cutaneous nerves of the hand, these blocks are usually more complete than conventional wrist blocks. Because the flexors and extensors of the arm at the elbow are spared, no arm sling is necessary following forearm blocks.