The final choices would be a function of the procedure done. For example, a wrist fusion requiring hip bone graft would be best done under general anesthesia. Here is a list of the common techniques
Monitored Anesthesia Care (MAC). This is local anesthesia with intravenous sedation. This works well for superficial surgeries such as carpal tunnel repair.
General Anesthesia
The technique in which local anesthesia is injected into the veins of the arm is a Bier Block. The local anesthetic is held in the arm by inflation of a blood pressure cuff around the biceps. This block works well for procedures lasting under one hour.
The nerves that supply your arm originate from a complex web of nerves known as the brachial plexus. The technique of axillary block involves the numbing of these nerves under your arm. Blockade of these nerves in your neck is known as a supraclavicular block. One advantage of these blocks is the ability to provide analgesia into the post-operative period via use of long acting local anesthetics. These techniques are more suited to complex hand procedures.
