[Comparison of the efficacy and duration of three different methods of digital block]

ABSTRACT

Finger injuries are very common and majority of them can be treated under digital block anesthesia. Traditional digital block is one of the most commonly performed blocks performed by care providers in several medical fields. There are two other less known methods, transthecal [pulley] block, in which local anesthesia is injected into the flexor tendon sheat that needs less volume of anesthesia and hasnot neurovascular complications and subcutaneous block in which local anesthesia is injected subcutaneously at the level of A1 pulley. This study aimed to compare the results of the three methods of digital block. A prospective randomized clinical trial was performed at Kashani hospital to compare the less known transthecal [pulley] and subcutaneous methods with traditional digital block with regard to the length of anesthesia and need to another anesthetic method [due to insufficient anesthesia] as a supplement. We divided 150 patients that were admitted to kashani hospital operating room due to finger injury, randomly, into three groups. In each group the patients were anesthetized by one of the three different methods. All blocks were performed by the same investigator. Data were analyzed by SPSS software using T test. Mean length of anesthesia was 34.2 min's in the transthecal digital block method and 34 min's in the subcutaneous method and 33.8 min's in the traditional digital block method. A repeat injection or local infiltration as a supplement was necessary in 5 instances [7 blocks] in the traditional digital block method and 9 instances [11 blocks] in the subcutaneous method [p < 0.05]. Regarding fewer injections and less amount of lidocaine and no risk of damaging the neurovascular bundles and comparable length of anesthesia and no need to supplemental anesthesia, transthecal digital block is an appropriate alternative to traditional digital block and subcutaneous inje