an ultrasound guided median nerve block can provide excellent anesthesia either for pain control or further procedures that need to be performed in the distal forearm or the hand to complete the procedure I'm going to use here the pal scanner on a nerve preset and I'm going to place the scanner roughly halfway between the wrist and the elbow in a transverse orientation just in the middle of that forearm and what I'm looking for is a honeycomb structure to represent the median nerve once I've identified it I can scan up and down to ensure it's not a tendonous structure but actually the nerve itself get it into a point of view that I like and from here you can block that nerve either from the medial or the lateral aspect in longitudinal plane bathe it with anesthesia and you get distal anesthesia for the median nerve distribution of the hand it's often combined with another forearm block to facilitate whatever it is anesthesia or analgesia you need of the distal forearm
