What is an ulnar nerve block?
An ulnar nerve block is a procedure to numb the side of the hand with the little finger. An anesthetic solution is injected adjacent to the ulnar nerve in the wrist or the elbow. The anesthetic blocks the transmission of pain signals from an injured portion of the hand to the brain.
The ulnar nerve is one of the terminal branches of the brachial plexus, a network of nerves under the collarbone that transmits sensory and motor information of the shoulder, arm, forearm, and hand. The brachial plexus nerve roots emerge from the spine in the neck and pass behind the collarbone and down the arm, dividing into multiple branches.
The following three nerves and their branches provide sensation to the hand:
- Radial nerve
- Median nerve
- Ulnar nerve
The ulnar nerve and its branches provide sensation and motor function to the side of the hand with the little finger. The ulnar nerve block provides anesthesia to:
- The little finger
- One side of the ring finger
- The part of the palm and back of the hand below the little finger and mid-line of the ring finger
Why is an ulnar nerve block performed?
An ulnar nerve block may be performed as a single procedure or in combination with a radial and/or median block, as needed. An ulnar nerve block is usually done for one of the following reasons:
- Anesthesia for surgical procedures.
- Pain relief (analgesia) for acute pain, post-surgery or from injury.
- Pain management for chronic pain from certain conditions such as:
- Ulnar nerve neuropathy: Numbness, weakness, tingling and pain, due to ulnar nerve irritation.
- Failed ulnar nerve transposition: Lack of pain relief from changing the position of the ulnar nerve to prevent irritation.
An ulnar nerve block is administered in situations that include:
- Incomplete anesthesia in the hand from a brachial plexus nerve block (administered in the neck or under the collarbone)
- Creation of a surgical connection between an artery and vein in the hand (arteriovenous fistula) for the purpose of hemodialysis
- Surgical procedures involving the hand and fingers
- Repair of lacerations and fractures in the hand and fingers
- Treatment of
- Cellulitis in the hand
- Nail infections
- Abscesses
- Burn injuries
- Implantation of a nerve stimulator to treat chronic pain from neuropathy
QUESTION
Medically speaking, the term "myalgia" refers to what type of pain? See AnswerHow is an ulnar nerve block done?
An ulnar nerve block is most often performed by a hand surgeon as an outpatient procedure in the emergency room. The two most common approaches for the ulnar block injection are:
- Above the elbow joint on the inside of the arm
- Above the wrist crease on the inside of the forearm
Anesthesia
The anesthetic agent used may be
- Lidocaine or mepivacaine for short- and fast-acting blocks
- Bupivacaine or ropivacaine for longer-lasting blocks
Preparation
- The patient lies flat with their hand appropriately positioned.
- The doctor does a physical examination of the hand to assess its neurovascular function.
- The injection site is sterilized with an antiseptic solution.
Procedure
The doctor
- Uses ultrasound guidance during the entire procedure for accurate positioning and needle angle and administration of the anesthetic.
- May use a nerve stimulator to confirm the correct location of the nerve by producing a tingling sensation.
- Sterilizes the injection site with antiseptic.
- Inserts the needle and slowly injects the anesthetic.
- Withdraws the needle and massages the injection site gently to help the solution spread in the tissues.
- Waits for up to 10 minutes for the nerve block to take effect.
- Will instruct the patient on caring for their hand as anesthetized extremities are at a greater risk of injury, especially with long-lasting anesthetics.
How long does an ulnar nerve block last?
The duration of the ulnar nerve block’s effects depends on the kind and quantity of anesthetic agent used. Anesthetic effects may last for up to five hours, but analgesic effects may last for approximately
- Lidocaine/mepivacaine: Three to eight hours
- Bupivacaine: Five to 30 hours
The patient may experience tingling, discomfort or pain as the ulnar nerve block wears off. Residual pain may be resolved with oral painkillers.
What are the risks and complications of an ulnar nerve block?
Ulnar nerve blocks are generally safe, especially as they are performed with ultrasound guidance. Potential complications include:
- Infection at the injection site
- Pain at the injection site
- Bleeding at the injection site
- Hematoma
- Nerve injury
- Injury to blood vessel
- Allergic reaction to the local anesthetic
- Local anesthetic systemic toxicity
- Unsuccessful nerve block
Top How Long Does an Ulnar Nerve Block Last Related Articles
Broken Bone
A broken bone is a fracture. There are different types of fractures, such as:- compressed,
- open,
- stress,
- greenstick,
- spiral,
- vertebral compression,
- compound, and
- comminuted.
Symptoms of a broken bone include pain at the site of injury, swelling, and bruising around the area of injury. Treatment of a fracture depends on the type and location of the injury.
Broken Bones
Broken bones are a common type of injury. Bones are some of the hardest tissues in the body, but they can break when they are stressed. Osteoporosis and cancer may cause bone fractures. The broken bone needs immediate medical treatment.
Broken Finger
The most common causes of broken fingers are a traumatic injury to the finger or fingers such as playing sports, injury in the workplace, falls, and accidents. Treatment for a broken finger may be as simple as buddy taping the broken finger to the adjacent finger, or if the fracture is more serious, surgery. Fingers are the most commonly injured part of the hand.
Burns
Burn types are based on their severity: first-degree burns, second-degree burns, and third-degree burns. First-degree burns are similar to a painful sunburn. The damage is more severe with second-degree burns, leading to blistering and more intense pain. The skin turns white and loses sensation with third-degree burns. Burn treatment depends upon the burn location, total burn area, and intensity of the burn.
Can Nerve Damage Heal on Its Own?
Damage to nerves can be severe. Because of their structure and function, nerves do not heal as quickly as some body parts do, but sometimes nerve damage can heal on its own.
First Aid: Why You Need a First Aid Kit and CPR
First aid is providing medical assistance to someone a sick or injured person. The type of first aid depends on their condition. Preparedness is key to first aid, like having basic medical emergency kits in your home, car, boat, or RV. Many minor injuries may require first aid, including cuts, puncture wounds, sprains, strains, and nosebleeds. Examples of more critical first aid emergencies include heart attacks, strokes, seizures, and heatstroke.
First Aid: Bandaging Injuries and Wounds From Head to Toe
Bandaging a wound like a burn, cut, or scrape requires different techniques depending on which part of the body was hurt. Ace bandages, liquid bandages, bandage wraps, waterproof bandages, elastic bandages, and other types are available to cover and protect your wound from dirt and water.
First Aid: Wound Care for Cuts and Scrapes
Wound care treatment at home involves performing cuts and scrapes first aid including cleaning the injury and applying antibiotic ointment and a bandage. Use wound care products like adhesive bandages, hypoallergenic bandages, sprays, tape, and gauze. If cuts and scrapes don’t heal, see your doctor.
8 First Aid Kit Essentials for Scrapes, Cuts, Bug Bites, and More
Are you always prepared for a first aid crisis? See which basic first aid items to pack to treat minor scrapes, cuts, and stings when you're on the go.
How Is a Sural Nerve Block Performed?
A sural nerve block is a procedure to numb the outer (lateral) side of the calf, lower leg, heel, edge of the foot and the top part of the little toe. A sural nerve block is most often performed as an outpatient procedure in the emergency department to treat injuries in the lower leg.
How Long Does A Digital Nerve Block Last?
A digital nerve block is a procedure to anesthetize the fingers or toes (digits) by injecting an anesthetic solution at the base of the digit. The injection is widely used for local anesthesia, especially in the emergency department, where people often come in with digital injuries.
How Long Does a Supraclavicular Nerve Block Last?
A supraclavicular nerve block is a procedure to block the sensation in the arm below the shoulder. An anesthetic injection is administered in the area above the collarbone (clavicle) close to the network of nerves (brachial plexus) that provides sensation to the upper extremities. A supraclavicular nerve block is the quickest and most effective block for the entire arm because the nerves are tightly packed in the targeted anatomical region (brachial plexus).
Nerve Blocks
Nerve blocks are used for different pain treatment and management purposes. There are many different types of nerve blocks for specific areas of the body. A plexus or ganglion is a group of nerves that causes pain to a specific area of the body. The pain area is injected with a nerve-numbing substance called a nerve block.
Trauma/First Aid Quiz
What should be in your first-aid kit? Take this quiz to understand trauma and learn the truth about how to administer first aid.
What Is an Infraclavicular Nerve Block?
An infraclavicular nerve block is a procedure to numb the brachial plexus nerves, which transmit sensation of the arms. An anesthetic injection is administered below the collarbone (clavicle), adjacent to the brachial plexus, to block the transmission of pain signals to the brain.