# Effectiveness of Regional Nerve Blocks Versus Local Anesthetic Infiltration for Elective Hand and Wrist Surgery

## TL;DR

This study compares pain relief methods for hand and wrist surgery, finding that ultrasound-guided nerve blocks last longer, while local anesthetic infiltration better controls pain severity.

## Contribution

The study provides a direct comparison of pain relief effectiveness and duration between three anesthetic techniques for hand and wrist surgery.

## Key findings

- Ultrasound-guided nerve blocks provided longer pain relief than local infiltration and anatomical landmark blocks.
- Local anesthetic infiltration was more effective in controlling pain severity compared to other methods.
- Patients receiving local infiltration reported better pain control for mild and severe pain.

## Abstract

Background: Pain relief by different methods in elective hand and wrist surgery is pivotal for patients undergoing elective wrist and hand surgery.

Aim: To evaluate the effectiveness and duration of peripheral nerve block versus local surgical site anesthetic infiltration among patients undergoing elective wrist and hand surgery.

Subjects and methods: This study was carried out in the Orthopaedic Department of Duhok Emergency Teaching Hospital, Duhok, Kurdistan region, Iraq. All patients who attended the Orthopaedic Department (total number=496) for elective hand and wrist surgery between November 2021 and November 2022 were included in the study, but only 300 patients completed the study protocol after the exclusion of 196 patients. Three methods of nerve block were used for postoperative pain relief. The degree and duration of pain relief were assessed.

Results: Patients who underwent ultrasound-guided nerve block had more duration of pain relief when compared to those patients who underwent local surgical site anesthetic infiltration and anatomical landmark nerve block (p<0.01), while patients who underwent local surgical site anesthetic infiltration had better pain relief when compared to those patients who underwent ultrasound-guided nerve block and anatomical landmark nerve block (p<0.01 for the group experiencing mild pain and p=0.12 for the group experiencing moderate pain and p<0.01 for the group experiencing severe pain).

Conclusion: Ultrasound-guided nerve block is better for a longer duration of pain relief postoperatively than local surgical site anesthetic infiltration, while local surgical site anesthetic infiltration more effectively controls the severity of pain following elective hand and wrist surgery.