II. Indications
- Anesthesia of Radial Nerve distribution distal to wrist
III. Precautions
- Avoid injecting directly into Radial Nerve
- Avoid injection into radial artery
IV. Preparation
- Needle: 27 gauge 1.5 inch
- Skin preparation (e.g. Hibiclens or Betadine)
-
Anesthetic
- See Regional Anesthesia for Anesthetic options
- Local Anesthetic 2-5 ml (Ultrasound) or 5-10 ml (landmark)
V. Technique: Ultrasound-Guided (preferred)
- Images
- Position
- Wrist and hand resting on the ulnar aspect with the thumb upwards
-
Ultrasound Probe
- Linear Probe transverse to Forearm over the radial aspect, 2 cm proximal to the radial styloid
- Injection
- Direct the needle towards proximal Forearm
- Inject into the perineural space
VI. Technique: Landmarks
- Images
- Position
- Wrist and hand resting on the ulnar aspect with the thumb upwards
- Insertion site
- Insert needle 1-2 cm proximal and lateral to radial styloid
- Direct needle at 10-20 degree angle distally toward thumb
- Inject into subcutaneous tissue
- Warning: Distal Paresthesias with needle with injection
- Indicates needle is at Radial Nerve
- Do not inject here!
- Remove needle and reposition
VII. References
- Pfenninger (1994) Procedures, Mosby, p. 1036-54
- Salam (2004) Am Fam Physician 69(4):896 [PubMed]
- Yurgil (2020) Am Fam Physician 101(11):654-64 [PubMed]
