Selective Nerve Block Combined With Tumescent Anesthesia

J Hand Surg Am. 2015 Dec;40(12):2339-44. doi: 10.1016/j.jhsa.2015.08.027. Epub 2015 Oct 30.


Purpose: To evaluate the effect of selective nerve blocks before tumescent anesthesia on the pain and anxiety levels of patients.

Methods: A prospective study was performed with 80 patients. Forty consecutive patients received tumescent anesthesia, and 40 consecutive patients received selective nerve blocks followed by tumescent anesthesia. Patients filled out a questionnaire regarding their preoperative, intraoperative, and postoperative pain and anxiety levels. The results of the questionnaire were evaluated with an independent samples t test.

Results: The 2 study groups showed similar distribution in age, sex, and diagnosis. No complications related to tumescent anesthesia or nerve blocks were observed. The group that received tumescent anesthesia with selective nerve blocks reported lower pain scores in anesthesia injections than the group that received tumescent anesthesia alone. The intraoperative and postoperative pain and anxiety levels between the groups were not different.

Conclusion: Tumescent anesthesia combined with selective nerve blocks in hand surgery decreased the pain associated with injections and increased patient satisfaction.

Type of study/level of evidence: Therapeutic I.

Keywords: Anesthesia; hand; nerve; tumescent; wide-awake.

MeSH terms

  • Adult
  • Aged
  • Anesthesia, Local / methods*
  • Female
  • Hand Injuries / surgery*
  • Humans
  • Male
  • Middle Aged
  • Nerve Block / methods*
  • Pain Measurement
  • Patient Satisfaction
  • Prospective Studies
  • Surveys and Questionnaires
  • Treatment Outcome