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Digital Block

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1. Should I Use Lidocaine with Epinephrine in Digital Nerve Blocks?

Should I Use Lidocaine with Epinephrine in Digital Nerve Blocks? TAKE-HOME MESSAGE There is inadequate evidence to support or discourage the combination of epinephrine with lidocaine for digital nerve blocks. Should I Use Lidocaine With Epinephrine in Digital Nerve Blocks? EBEM Commentators Julie L. Welch, MD Dylan D. Cooper, MD Indiana University School of Medicine Indianapolis, IN Results Of the 1,164 identi?ed studies, only 4 met inclusion criteria for analysis, which included 167 pa- tients (...) . None of the studies were deemed to be high quality ac- cording to risk-of-bias analysis. Three studies used epinephrine with lidocaine concentration 1:100,000, whereas 1 used 1:200,000. Only 1 study reported prolonged anesthesia duration with epinephrine with lidocaine, and 2 studies demonstrated a reduction of bleeding during surgery. No studies reported any adverse events (eg, digital ischemia) in the lidocaine with epinephrine group. Commentary Digital nerve blocks are common procedures

2016 Annals of Emergency Medicine Systematic Review Snapshots

2. Appropriate Digital Nerve Block Technique: The Single-Injection Subcutaneous Volar Block Versus the Two-Injection Dorsal Digital Block

Appropriate Digital Nerve Block Technique: The Single-Injection Subcutaneous Volar Block Versus the Two-Injection Dorsal Digital Block "Appropriate Digital Nerve Block Technique: The Single-Injection Subcut" by Roman Madsen < > > > > > Title Author Date of Graduation Summer 8-8-2015 Degree Type Capstone Project Degree Name Master of Science in Physician Assistant Studies First Advisor Annjanette Sommers, MS, PA-C Rights . Abstract Background: Finger injuries are a common chief complaint (...) in the emergency department (ED) and primary care setting. Repair of these injuries often require digital anesthesia through performing a digital nerve block (DNB). The two-injection subcutaneous volar block (SVB) and a two-injection dorsal digital block (DDB) are two of the most prevalently performed digital blocks in practice today. This systematic review examines which DNB technique is most appropriate and attempts to offer a recommendation for a standardized level of care. Methods: An extensive literature

2015 Pacific University EBM Capstone Project

3. The Influence of Injected Volume on Discomfort During Administration of Digital Block. (PubMed)

The Influence of Injected Volume on Discomfort During Administration of Digital Block. Digital nerve block is associated with pain. In a search for methods to reduce the discomfort, we investigated how the volume of anaesthetic fluid influences pain during subcutaneous digital nerve block, and how it affects the success of the anaesthesia.A randomized blinded prospective study was performed on 36 healthy volunteers. The single injection subcutaneous digital block technique was used (...) to anaesthetize the participants´ 4th digit on both hands. The same amount of lidocaine was used, but in two different volumes; 1 ml 2% lidocaine and 2ml 1% lidocaine. After each injection the participant was asked to estimate pain intensity on a visual analogue scale (VAS). The distribution of anaesthesia was then measured by using a Semmes-Weinstein 4.56 monofilament. Finally, participants gave a verbal assessment of which injection was least painful.In total, 72 blocks were performed. There were

2018 The journal of hand surgery Asian-Pacific volume

4. Effectiveness of proximal interphalangeal joint-blocking orthosis vs metacarpophalangeal joint-blocking orthosis in trigger digit management: A randomized clinical trial. (PubMed)

Effectiveness of proximal interphalangeal joint-blocking orthosis vs metacarpophalangeal joint-blocking orthosis in trigger digit management: A randomized clinical trial. Patients with Green's classification grade 2 or 3 A1-pulley trigger digit (TD) were recruited and randomized to receive the proximal interphalangeal joint-blocking orthosis (PIPJ-BO) or metacarpophalangeal joint-blocking orthosis (MCPJ-BO).TD is a common hand condition that can affect one's performance in activities of daily

2018 Journal of hand therapy : official journal of the American Society of Hand Therapists

5. Two injection digital block versus single subcutaneous palmar injection block for finger lacerations. (PubMed)

Two injection digital block versus single subcutaneous palmar injection block for finger lacerations. We aimed to compare two digital nerve block techniques in patients due to traumatic digital lacerations.This was a randomized-controlled study designed prospectively in the emergency department of a university-based training and research hospital. Randomization was achieved by sealed envelopes. Half of the patients were randomised to traditional (two-injection) digital nerve block technique (...) while single-injection digital nerve block technique was applied to the other half. Score of pain due to anesthetic infiltration and suturing, onset time of total anesthesia, need for an additional rescue injection were the parameters evaluated with both groups. Epinephrin added lidocaine hydrochloride preparation was used for the anesthetic application. Visual analog scale was used for the evaluation of pain scores. Outcomes were compared by using Mann-Whitney U test and Student t-test.Fifty

2018 European journal of trauma and emergency surgery : official publication of the European Trauma Society

6. The effect of a compression bandage on the distribution of radiodense contrast medium after palmar digital nerve blocks. (PubMed)

The effect of a compression bandage on the distribution of radiodense contrast medium after palmar digital nerve blocks. Studies have shown proximal diffusion of injected drugs in perineural blocks; such diffusion may affect specificity of the nerve block.To investigate the effect of a compression bandage applied to the pastern region on proximal diffusion of contrast medium injected over the palmar digital nerves.Experimental study, randomised cross-over design.Radiodense contrast medium (...) was injected over the lateral and medial palmar digital nerves of the left front limb of nine mature horses. Each horse was injected on two separate occasions, once with a 5 cm wide compression bandage applied proximal to the injection site and once without. The order of the two treatments was randomised with a wash-out period between treatments of at least 7 days. Radiographs were obtained at 5, 10, 20 and 30 min and distribution of the contrast column assessed.Proximal distribution of the contrast medium

2019 Equine veterinary journal

7. Use of a Dental Vibration Tool to Reduce Pain From Digital Blocks: A Randomized Controlled Trial

Use of a Dental Vibration Tool to Reduce Pain From Digital Blocks: A Randomized Controlled Trial The infiltration of local anesthetic is consistently described as painful by patients. Vibration anesthesia has been studied in the dental literature as a promising tool to alleviate the pain from dental nerve blocks. Many of these studies used a specific device, the DentalVibe. To date, there have not been any studies applying this technology to digital blocks of the hand in human subjects. We (...) hypothesized that the use of microvibratory stimulation during digital blocks of the hand would decrease pain reported by patients.This was a randomized controlled trial of consenting adult emergency department patients who received digital block anesthesia for hand digit therapy when study authors were present. The study period was 24 months at an academic emergency department. A sample size of 50 injections (25 subjects) was necessary for a power of 80% to detect a mean difference of 2 (SD, 2.5

2017 EvidenceUpdates

8. Pigmented border as a new surface landmark for digital nerve blocks: a cross sectional anatomical study. (PubMed)

Pigmented border as a new surface landmark for digital nerve blocks: a cross sectional anatomical study. The purpose of this study was to identify surface anatomy of digital nerves in relation to the pigmented border of digits. Three-hundred and sixty digital nerves in 36 preserved adult cadaveric hands were dissected under magnification. The digital nerves were constantly located anterior to the pigmented border. The median curvilinear distance along the skin from the pigmented border (...) to the digital nerves of the index, middle, ring and little fingers was 1.4 mm. In the thumb, this distance was 2.4 and 3.7 mm on the radial and ulnar sides, respectively. The digital nerve was located 2.4 mm deep to the skin in all fingers. The median angle to the nerve from the skin at the pigmented border was 30°. These dimensions differed in the thumb compared with the rest of the fingers. We conclude that the pigmented border of digits is a reliable anatomical landmark to locate digital nerves.

2019 Journal of Hand Surgery - European

9. Changes in facial temperature measured by digital infrared thermal imaging in patients after transnasal sphenopalatine ganglion block: Retrospective observational study. (Full text)

Changes in facial temperature measured by digital infrared thermal imaging in patients after transnasal sphenopalatine ganglion block: Retrospective observational study. Sphenopalatine ganglion block (SPGB) is a technique developed in the 1990s for the management of head and neck pain patients. Recently, transnasal sphenopalatine ganglion block (TN-SPGB) has been widely used for these patients; however, no objective methods exist for validating the success of TN-SPGB. In this study, we measured (...) the changes in facial temperature before and 30 minutes after TN-SPGB by using digital infrared thermal imaging (DITI) to validate its success.The medical records of patients, who underwent TN-SPGB and facial DITI between January 2016 and December 2017, were reviewed. TN-SPGB and facial DITI were performed 36 times in 32 patients. The changes in facial temperatures measured at the forehead (V1), maxillary area (V2), and mandibular area (V3) by using DITI before and 30 minutes after TN-SPGB were recorded

2019 Medicine PubMed

10. The difference of subcutaneous digital nerve block method efficacy according to injection location. (PubMed)

The difference of subcutaneous digital nerve block method efficacy according to injection location. Finger injuries are commonly attended to in the emergency department, and digital nerve block is a frequently performed procedure for such injuries. This study compared the efficacy levels of the subcutaneous method according to the different injection sites.This was a simulation study for medical students who rendered medical service at the emergency department. One group performed subcutaneous

2019 American Journal of Emergency Medicine

11. Ultrasound-guided peripheral forearm nerve block for digit fractures in a pediatric emergency department. (PubMed)

Ultrasound-guided peripheral forearm nerve block for digit fractures in a pediatric emergency department. Although ultrasound-guided peripheral nerve block (UGPNB) has recently been introduced into pediatric emergency departments (EDs), knowledge of its use is still limited among pediatric emergency physicians. Ultrasound-guided ulnar nerve block (UGUNB) is a form of peripheral nerve block available for controlling the pain caused by phalangeal injuries, but studies of its use in pediatric (...) patients are still scarce. The aim of this case series was to describe the experience of UGUNB use for pediatric phalangeal fractures in a pediatric ED setting. In all the patients with phalangeal fractures, the ulnar nerve was successfully visualized using a hockey-stick type transducer. Approximately 0.1-0.2 mg/kg of 1% lidocaine was used as the nerve block. The procedure was effective for pain control, and fracture reduction was successfully performed without the need for rescue analgesia. This case

2018 American Journal of Emergency Medicine

12. Intranasal ketamine reduces pain of digital nerve block; a double blind randomized clinical trial. (PubMed)

Intranasal ketamine reduces pain of digital nerve block; a double blind randomized clinical trial. Low dose ketamine can be used as analgesic in acute pain management in the emergency department (ED).Efficacy of IN ketamine in acute pain management in the ED.This is a double blind randomized clinical trial on patients older than 15 years who needed digital nerve block (DNB). Participants randomly received IN Ketamine (1 ml = 50 mg) or placebo (normal saline, 1 ml) 5 min before DNB. In both (...) score was 50 (15) in ketamine group, and 49 (27) in control group. Median (IQR) block pain VAS score was 28.5 (19) in ketamine group and 47.5 (31) in control group. Median (IQR) procedural pain VAS score was 21.5 (16) in ketamine group and 43.5 (29) in control group. Only 7 patients had adverse effects in either group.The findings of this study suggest that IN ketamine can be effective in reducing pain in patients with acute pain, without adding significant side effects.Copyright © 2018 Elsevier Inc

2018 American Journal of Emergency Medicine

13. Use of a Dental Vibration Tool to Reduce Pain From Digital Blocks: A Randomized Controlled Trial. (PubMed)

Use of a Dental Vibration Tool to Reduce Pain From Digital Blocks: A Randomized Controlled Trial. The infiltration of local anesthetic is consistently described as painful by patients. Vibration anesthesia has been studied in the dental literature as a promising tool to alleviate the pain from dental nerve blocks. Many of these studies used a specific device, the DentalVibe. To date, there have not been any studies applying this technology to digital blocks of the hand in human subjects. We (...) hypothesized that the use of microvibratory stimulation during digital blocks of the hand would decrease pain reported by patients.This was a randomized controlled trial of consenting adult emergency department patients who received digital block anesthesia for hand digit therapy when study authors were present. The study period was 24 months at an academic emergency department. A sample size of 50 injections (25 subjects) was necessary for a power of 80% to detect a mean difference of 2 (SD, 2.5

2018 Regional Anesthesia and Pain Medicine

14. Use of a Dental Vibration Tool to Reduce Pain From Digital Blocks: A Randomized Controlled Trial. (PubMed)

Use of a Dental Vibration Tool to Reduce Pain From Digital Blocks: A Randomized Controlled Trial. The infiltration of local anesthetic is consistently described as painful by patients. Vibration anesthesia has been studied in the dental literature as a promising tool to alleviate the pain from dental nerve blocks. Many of these studies used a specific device, the DentalVibe. To date, there have not been any studies applying this technology to digital blocks of the hand in human subjects. We (...) hypothesized that the use of microvibratory stimulation during digital blocks of the hand would decrease pain reported by patients.This was a randomized controlled trial of consenting adult emergency department patients who received digital block anesthesia for hand digit therapy when study authors were present. The study period was 24 months at an academic emergency department. A sample size of 50 injections (25 subjects) was necessary for a power of 80% to detect a mean difference of 2 (SD, 2.5

2017 Regional Anesthesia and Pain Medicine

15. Siemens Revelation digital breast tomosynthesis evaluation

by imaging a geometric test phantom consisting of a rectangular array of 1mm diameter aluminium balls at 50mm intervals in the middle of a 5mm thick sheet of PMMA. The phantom was placed at various heights (7.5, 32.5, and 52.5mm) within a 60mm stack of plain sheets of PMMA. The block of PMMA was tilted using the same method as used in section 2.3. Reconstructed tomosynthesis planes Technical evaluation of Siemens Revelation digital breast tomosynthesis system 10 were analysed to find the height (...) Siemens Revelation digital breast tomosynthesis evaluation NHS Breast Screening Programme Equipment Report Technical evaluation of Siemens Revelation digital breast tomosynthesis system March 2019 Technical evaluation of Siemens Revelation digital breast tomosynthesis system 2 About Public Health England Public Health England exists to protect and improve the nation’s health and wellbeing, and reduce health inequalities. We do this through world-leading science, knowledge and intelligence

2019 Public Health England

16. Breast screening: Planmed Clarity digital mammography in 2D mode

, 40mm from the CWE of each image. The average pixel value and the standard deviation of pixel values within the ROI were measured. The relationship between average pixel values and the incident air kerma to the detector was determined. Technical evaluation of Planmed Clarity digital mammography system in 2D mode 8 2.4 Dose measurement Doses were measured using the X-ray set’s Full Field Flex-AEC mode to expose different thicknesses of PMMA. Each PMMA block had an area of 180mm x 240mm. Spacers were (...) blocking the X-ray beam and 80mm of PMMA, the exposure terminated after a short time of less than a second following the pre-exposure. There was no main exposure and no image was acquired. Technical evaluation of Planmed Clarity digital mammography system in 2D mode 33 4. Discussion 4.1 Dose and contrast-to-noise ratio The detector response was found to be linear. This was as expected for Planmed systems. MGDs measured using PMMA were well within the NHSBSP remedial dose levels for all equivalent

2019 Public Health England

17. Siemens Revelation digital mammography system in 2D mode evaluation

e F it to d a ta m e a n p ixe l va lueTechnical evaluation of Siemens Revelation digital mammography system in 2D mode 16 3.3 AEC performance 3.3.1 Dose The MGDs for breasts simulated with PMMA exposed under AEC control are shown in Tables 6 and 7 for exposures made in grid mode and with PRIME respectively. These results were acquired with segmentation off, which is appropriate for physics measurements of uniform blocks. The mAs values exclude the pre-exposure. The MGDs were calculated from (...) with a brass plate blocking the X-ray beam and 80mm of PMMA, the exposure terminated after a short time of less than a second following the pre-exposure. There was no main exposure and no image acquired. 3.9.9 Focal spot The measured dimensions of the focal spot were 0.37mm x 0.33mm in broad focus and 0.17mm x 0.14mm in fine focus. 3.9.10 Mesh No discontinuities or blurred regions were seen in the image of the mesh test object. Technical evaluation of Siemens Revelation digital mammography system in 2D

2019 Public Health England

18. Breast screening: Hologic 3D digital mammography system in 2D mode

using the standard size blocks of PMMA, as it was not possible to position the paddle at the required height due to its curvature. The required thickness of PMMA was therefore assembled using blocks of different sizes as shown in Figure 10. Technical evaluation of Hologic 3Dimensions digital mammography system 31 Figure 20. 18cm x24cm curved paddle with PMMA Technical evaluation of Hologic 3Dimensions digital mammography system 32 Table 17. Exposure factors and displayed MGD for simulated breasts (...) Breast screening: Hologic 3D digital mammography system in 2D mode NHS Breast Screening Programme Equipment Report Technical Evaluation of Hologic 3Dimensions digital mammography system in 2D mode March 2019Technical evaluation Hologic 3Dimensions digital mammography system in 2D mode 2 About Public Health England Public Health England exists to protect and improve the nation’s health and wellbeing, and reduce health inequalities. We do this through world-leading science, knowledge

2019 Public Health England

19. WHO Guideline: recommendations on digital interventions for health system strengthening

WHO Guideline: recommendations on digital interventions for health system strengthening WHO guideline recommend ations on digital interventions for health system strengtheningWHO guideline recommend ations on digital interventions for health system strengthening page ii WHO guideline: recommendations on digital interventions for health system strengthening ISBN 978-92-4-155050-5 © World Health Organization 2019 Some rights reserved. This work is available under the Creative Commons Attribution (...) with the mediation rules of the World Intellectual Property Organization. Suggested citation. WHO guideline: recommendations on digital interventions for health system strengthening. Geneva: World Health Organization; 2019. Licence: CC BY-NC-SA 3.0 IGO. Cataloguing-in-Publication (CIP) data. CIP data are available at http://apps.who.int/iris. Sales, rights and licensing. To purchase WHO publications, see http://apps.who.int/bookorders. To submit requests for commercial use and queries on rights and licensing

2019 World Health Organisation Guidelines

20. Comparison of transthecal digit block and single injection volar subcutaneous digit block. (PubMed)

Comparison of transthecal digit block and single injection volar subcutaneous digit block. Background. A study was designed to compare the efficacy of anesthesia between transthecal digit block (TDB) and single injection volar subcutaneous block.A 36-patient, randomized, controlled, prospective investigation was undertaken. The parameters included the onset of time to achieve anesthesia, visual analog scale pain score during the infiltration, and anesthesia duration.The mean (...) time of the onset of anesthesia was 120 ± 8.9 seconds for transthecal blocks compared with 140 ± 7.8 seconds for the single injection volar subcutaneous digit blocks, and the mean time to loss of anesthesia was 3 ± 0.12 hours versus 4.3 ± 0.21 hours, respectively. The pain score was 3.1 ± 0.12 versus 2.4 ± 0.17. The difference among the three parameters between the two groups was statistically significant (P <0.05).These results confirm the efficacy of the transthecal block and the single injection

2015 Wounds : a compendium of clinical research and practice

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