Valsalva manoeuvre and the wrist block

Valsalva manoeuvre and the wrist block Eur J Plast Surg (2011) 34:421–422 DOI 10.1007/s00238-011-0567-0 LETTER TO THE EDITOR Syed Abuzar Mashhadi & Charles Yuen Yung Loh Received: 12 December 2010 /Accepted: 14 February 2011 /Published online: 4 May 2011 Springer-Verlag 2011 Sir, relief by VNS most likely relies on central inhibition rather Wrist block or median nerve block is commonly employed than the alteration of primary afferents. VNS has anticon- in hand surgery procedures. The commonest indication is vulsant, antidepressant and possible analgesic properties in carpal tunnel release. Pain during wrist or median nerve human beings [8]. block can be a very unpleasant and stressful experience for The VM is a well-known phenomenon associated with the patient. Many different methods have been proposed to increased sympathetic activity when decreasing venous reduce the severity of needle prick pain. Various topical blood flow back to the heart. This reflex is generated by local anaesthetics, topical skin analgesics, ethyl chloride, increasing intrathoracic pressure by exhaling against a ice and the cough trick have been described to decrease the closed glottis or blowing against resistance for a period of needle prick pain [1–5]. We have observed that when the time. This results in increased resistance of blood flow, and European Journal of Plastic Surgery Springer Journals

Valsalva manoeuvre and the wrist block

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Copyright © 2011 by Springer-Verlag
Medicine & Public Health; Plastic Surgery
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