Pharm

Ulnar Nerve Block at Elbow

search

Ulnar Nerve Block at Elbow, Regional Anesthesia of the Ulnar Nerve at Elbow

  • Indications
  1. Anesthesia of Ulnar Nerve distribution distal to elbow
  • Precautions
  1. Avoid injecting directly into Ulnar Nerve
  • Anatomy
  • Landmarks
  1. Medial Epicondyle
  2. Ulnar Nerve
  3. Olecranon
  • Preparation
  1. Needle: 27 gauge 1.5 inch
  2. Anesthetic
    1. See Regional Anesthesia for Anesthetic options
    2. Local Anesthetic 2-5 ml (Ultrasound) or 5-10 ml (landmark)
  3. Skin preparation (e.g. Hibiclens or Betadine)
    1. See Regional Anesthesia
  4. Position
    1. Patient supine
    2. Arm abducted 90 degrees, resting against table
    3. Flex elbow to 90 degrees
    4. Supinate Forearm
  1. Images
    1. ulnarNerveBlockElbowUltrasound.jpg
  2. Position patient as above
  3. Ultrasound probe
    1. Transverse to Forearm at level of medial epicondyle
  4. Injection
    1. Advance needle in-plane to Ultrasound probe
  • Technique
  • Landmark
  1. Images
    1. ulnarNerveBlockElbowLandmark.jpg
  2. Higher risk procedure due to risk of Ulnar Nerve injury
  3. Position patient as above
  4. Injection
    1. Insert needle between olecranon and medial epicondyle
    2. Direct needle distally at 30 degree angle
    3. Advance needle 0.5 cm deep
    4. Inject 3-5 ml of Anesthetic