Preparing for pisiform wrist surgery, what is best/longest lasting nerve block? is brachial axillary longer/wider cover than wrist block? any others?

Ancillary block: An axillary block would be my choice - these blocks are done under ultrasound guidance safely by trained anesthesiologists the wrist block can work but would not give relief from pain associated with a tourniquet if used by the surgeon. Axillary blocks may last up to 24 hours with the longer acting anesthetics and the addition of steroid.

That Depends..: Wrist blocks are used most often for procedures lasting 30 minutes or less, unless supplemented by other nerve blocks that allow forearm tourniquet placement. Length of anesthesia relates more to anesthetic used +/- Epinephrine than block technique. Brachial plexus blocks work well if supplemented by a musculocutaneous nerve block. Bottom line: rely on your experienced anesthesiologist to advise!