II. Indications
- Anesthesia of Ulnar Nerve distribution
III. Precautions
- Avoid injecting directly into Ulnar Nerve
- Avoid injection into ulnar artery
IV. Preparation
- Needle: 27 gauge 1.5 inch
- Anesthetic: Lidocaine 1%: 10 ml
V. Technique: Ulnar Nerve Block at wrist
- Injection site 1: Palmar branch of the Ulnar Nerve
- Between flexor carpi ulnaris tendon and ulnar artery
- Inject at depth of 1-2 cm at proximal wrist crease
- Needle parallel to wrist crease toward radius
- Injection site 2: Dorsal branch of the Ulnar Nerve
- Distal aspect of ulnar styloid process (dorsum)
- Infiltrate 3-4 ml subcutaneously
- Warning: Distal Paresthesias with needle with injection
- Indicates needle is at Ulnar Nerve
- Do not inject here!
- Remove needle and reposition
VI. Technique: Ulnar Nerve Block at elbow
- Higher risk procedure due to nerve injury
- Position
- Flex elbow to 90 degrees
- Injection
- Inject between olecranon and medial epicondyle
- Inject 3-5 ml at depth of 0.5 cm
VII. References
- Pfenninger (1994) Procedures, Mosby, p. 1036-54
- Salam (2004) Am Fam Physician 69(4):896 [PubMed]
