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Ulnar Nerve Block for Procedural Anesthesia - Wrist Versus Palm

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ClinicalTrials.gov Identifier: NCT00827658
Recruitment Status : Terminated
First Posted : January 23, 2009
Last Update Posted : May 14, 2018
Sponsor:
Collaborator:
McMaster University
Information provided by (Responsible Party):
McMaster University ( Hamilton Health Sciences Corporation )

Brief Summary:
Ulnar nerve blockade is necessary for sensory anesthesia and analgesia in the hand during minor procedures. The course of the ulnar nerve in the forearm, wrist, and hand is predictable and has low variability. However even with known anatomic location and landmarks, ulnar nerve blocks at the wrist frequently are inadequate for procedural anesthesia. The antebrachial fascia at the wrist acts as a barrier to local infiltration. Since the fascia can not be visualized or palpated, it is commonly not penetrated, resulting in an inadequate block. Furthermore at the level of the wrist the ulnar artery lies in close proximity to the nerve and there is potential for arterial puncture while attempting injection for volar wrist block. The palmar ulnar nerve block is an injection distal to the hook of the hamate in the thenar eminence which avoids the ulnar artery and antebrachial fascia. This block has been used successfully for many years in clinical practice but has not been assessed or compared in a research study. The purpose of this study is to assess the validity of using a palmar ulnar nerve block for procedures in the hand as compared to the standard volar wrist ulnar nerve block.

Condition or disease Intervention/treatment Phase
Hand Surgery Procedure: Volar Wrist Block Procedure: Hypothenar Palm block Not Applicable

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 127 participants
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: Single (Investigator)
Primary Purpose: Treatment
Official Title: Ulnar Nerve Block for Procedural Anesthesia - Wrist Versus Palm
Study Start Date : February 2008
Actual Primary Completion Date : July 2009
Actual Study Completion Date : July 2009

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Anesthesia
U.S. FDA Resources

Arm Intervention/treatment
Active Comparator: Hypothenar Palm block
Hypothenar Palmar block group. Local anesthetic is placed at this location in this study group. The same local composition (Intervention) is used for both study groups. The trial is a comparison of location not the Intervention.
Procedure: Hypothenar Palm block

Injection at Hook of the Hamate on Palmar surface

Local Block - total 3 cc injection (1.5 cc 1% plain lidocaine and 1.5 cc of 0.25% bupivicaine)

Active Comparator: Volar Wrist Block
Volar Wrist block group. Local anesthetic is placed at this location in this study group. The same local composition (Intervention) is used for both study groups. The trial is a comparison of location not the Intervention.
Procedure: Volar Wrist Block

Injection medial to Flexor Carpi Ulnaris Tendon at volar proximal wrist crease

Local Block - total 3 cc injection (1.5 cc 1% plain lidocaine and 1.5 cc of 0.25% bupivicaine)




Primary Outcome Measures :
  1. Primary outcome is efficacy of sensory anesthesia and analgesia [ Time Frame: 15-45 minutes ]

Secondary Outcome Measures :
  1. Secondary outcome is patient perceived discomfort with block [ Time Frame: 15-45 Minutes ]


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Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • any individual who can give informed consent and is scheduled for elective hand procedures by the PI necessitating an Ulnar nerve block of the hand.

Exclusion Criteria:

  • patients unable to give informed consent
  • patients with previous or ongoing ulnar nerve deficits or neuropathy
  • patients undergoing Guyon's canal decompression
  • patients who can not comprehend or cooperate with assessment testing
  • patients with abnormal two point discrimination (> 6 mm at the test location) prior to the nerve block

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00827658


Locations
Canada, Ontario
Hamilton General Hospital
Hamilton, Ontario, Canada
Sponsors and Collaborators
Hamilton Health Sciences Corporation
McMaster University
Investigators
Principal Investigator: Stuart Martin McMaster University

Responsible Party: Hamilton Health Sciences Corporation
ClinicalTrials.gov Identifier: NCT00827658     History of Changes
Other Study ID Numbers: McMaster 08-053
First Posted: January 23, 2009    Key Record Dates
Last Update Posted: May 14, 2018
Last Verified: May 2018

Keywords provided by McMaster University ( Hamilton Health Sciences Corporation ):
anesthesia, local
ulnar nerve
hand
surgery, plastic
blinded
randomized
prospective
local anesthesia
volar wrist block
hypothenar palm block
hand surgery

Additional relevant MeSH terms:
Anesthetics
Central Nervous System Depressants
Physiological Effects of Drugs