WALANT Versus Axillary Brachial Plexus Block in Carpal Tunnel Release

Injection of 30 mL of lidocaine (10 mg/ml) around the median, radial, ulnar and musculocutaneous nerves.

Inflation pressure 75 to 100 mmHg above the patient's systolic blood pressure.

Axillary block with Lidocaine (10 mg/ml).

"Preparation of a mixture of 20 ml of lidocaine (10 mg/ml) with epinephrine (0.005 mg/ml) + 3 ml Na bicarbonate (84 mg/ml) + 17 ml sterile normal saline.~The ultrasound probe will be placed to obtain a transverse image of the median nerve at the wrist. With an in-plane technique, a 50mm ultrasound needle (Ultraplex 360°, B Braun, Melsungen, Germany) will be advanced to achieve a spread of 5 ml of the solution posterior and then anterior to the median nerve under the annular carpal ligament.~Then the ultrasound probe will be placed to obtain a longitudinal image of the median nerve at the wrist. With an in-plane technique, a 50mm ultrasound needle (Ultraplex 360°, B Braun, Melsungen, Germany) will be advanced to achieve a spread of 15 ml of the solution anterior to the median nerve towards the carpal tunnel.~At last, a local infiltration with 5 ml of the solution will be performed around the surgical incision."

WALANT technique with lidocaine (10 mg/ml) combined with 0.005 mg/ml epinephrine.