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Carpal Tunnel Block Choice — FRCA Final MCQ

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ModerateDay SurgeryCarpal Tunnel Block ChoiceFRCA Final

A 35-year-old man (ASA I, 80 kg) is scheduled for carpal tunnel decompression as a day case. Which regional anaesthetic technique provides the most targeted block with the least motor impairment?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Wrist block (median nerve block at the wrist)

For carpal tunnel decompression (median nerve territory only), a targeted median nerve block at the wrist provides precise sensory anaesthesia to the operative field with minimal motor block, allowing rapid recovery and same-day discharge. Brachial plexus blocks (interscalene, supraclavicular, axillary) would provide excessive and prolonged motor block of the entire upper limb, delaying discharge and impairing function. Bier's block is an alternative but requires tourniquet tolerance and has a finite duration. Local infiltration by the surgeon is also commonly used.

Reference: BADS – 2019 – Directory of procedures; RCOA – 2023 – Regional anaesthesia module