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The Influence of Injected Volume on Discomfort During Administration of DigitalBlock. 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 digitalblock 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
Use of a Dental Vibration Tool to Reduce Pain From DigitalBlocks: 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 digitalblocks of the hand in human subjects. We (...) hypothesized that the use of microvibratory stimulation during digitalblocks of the hand would decrease pain reported by patients.This was a randomized controlled trial of consenting adult emergency department patients who received digitalblock 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
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
Appropriate Digital Nerve Block Technique: The Single-Injection Subcutaneous Volar Block Versus the Two-Injection Dorsal DigitalBlock "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 digitalblock (DDB) are two of the most prevalently performed digitalblocks 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
Epinephrine in digital nerve block BestBets: Epinephrine in digital nerve block Epinephrine in digital nerve block Report By: P P Mohan - Research Fellow, Gastrointestinal Surgery Search checked by PT Cherian - Specialist Registrar, Hepatobiliary Surgery Institution: Good Hope Hospital NHS Trust, Sutton Coldfield, University Hospital Birmingham, UK. Date Submitted: 22nd June 2006 Date Completed: 24th October 2007 Last Modified: 24th October 2007 Status: Green (complete) Three Part Question (...) In [adult patients with no underlying vascular compromise undergoing digitalblock] is [local anaesthetic with low dose epinephrine as safe as local anesthetic alone] at [achieving analgesia without causing ischaemic complications]? Clinical Scenario A 25-year-old man presents to the emergency department with a traumatic laceration to his left index finger. The wound needs a thorough clean and will require suturing and you decide to do this using a digital nerve block technique. A colleague who has
A comparison of traditional digitalblocks and single subcutaneous palmar injection blocks at the base of the finger and a meta-analysis of the digitalblock trials A comparison of traditional digitalblocks and single subcutaneous palmar injection blocks at the base of the finger and a meta-analysis of the digitalblock trials A comparison of traditional digitalblocks and single subcutaneous palmar injection blocks at the base of the finger and a meta-analysis of the digitalblock trials Yin (...) Z G, Zhang J B, Kan S L, Wang P CRD summary This review evaluated digitalblock techniques for treating finger injuries. The authors concluded that traditional digitalblocks and single subcutaneous palmar injection blocks produce similar injection pain, and are less painful than the transthecal digitalblock. Palmar techniques are associated with incomplete anaesthesia. Given the small number of variable and poor-quality studies, the reliability of the authors' conclusions is unclear. Authors