A novel technique of using percutaneous nerve catheter for post-operative analgesia and early mobilization in hand surgeries

Abstract

Objectives: The need for the early mobilization of the fingers after hand surgery cannot be overemphasized in the outcome of the patients. In hand surgeries, the open method of blocking the distal nerves at the distal forearm is well-known and practiced in some centers. The same with a closed method has not been practiced or published in the English literature. Methods: We performed the technique soon after the surgery when the patient was still under regional anesthesia/general anesthesia. Pain score was assessed using a numeric pain rating scale (NPRS) between post-operative day 1 and day 4 during the finger mobilization. Active metacarpophalangeal (MCP), proximal interphalangeal (PIP), and distal interphalangeal (DIP) joint movements were recorded using a goniometer. Results: NPRS improved from 2.88 ± 0.81 at post-operative day 1–1.69 ± 0.48 at post-operative day 4. Similarly, the range of motion of the MCP joint improved from 66.67 ± 12.31° to 82.67 ± 8.877°. The range of motion of the PIP joint significantly improved from 69.38 ± 26.95° to 85 ± 11.55°, respectively. Similarly, the range of motion of the DIP joint improved from 85 ± 11.55° to 69 ± 11.55°. We have not encountered any major complications such as infection, hematoma, or injury to tendons or nerves. Conclusion: The percutaneous nerve catheter is an excellent technique in hand surgeries for blocking peripheral nerves, thus providing analgesia and early rehabilitation.