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Effective anesthesia of the hand and wrist has many uses inside and outside the operating room. In the emergency department or fracture clinic, a wrist block may be used for closed reductions of dislocations and fractures or for effective inspection and treatment of wounds. In the operating room, surgery may be carried out under a wrist block alone or a wrist block may be used as an adjunct to general anesthesia as the block is an opiatesparing option to facilitate outpatient surgery and to provide many hours of postoperative analgesia, particularly if administered prior to the commencement of surgery.

The landmark technique for distal peripheral nerve blocks at the wrist is a wellrecognized method and is described for the median nerve, ulnar nerve, superficial branch of the radial nerve, and dorsal branch of the ulnar nerve at the wrist. To make this technique more effective for carpal surgery, blocks of the posterior interosseous and anterior interosseous nerves are added.