Purpose
The optimal volume of local anesthetic for transthecal digital block has not yet been
identified. The goal of this study was to understand the effect of different volumes
of local anesthetic using a modified transthecal digital block.
Methods
We performed a prospective, randomized, double-blinded, controlled study with normal
volunteers. The subjects were randomly divided into 3 groups receiving 1, 2, or 3
mL of 1% lidocaine using a modified transthecal digital block. An investigator blinded
to the assignment of subjects and dosages evaluated the onset, progression, and duration
of anesthesia. Threshold sensory testing was performed every minute in the first 10-minute
period and then at 15-minute intervals up to 85 minutes. Pain was assessed after infiltration
using the visual analog scale.
Results
A total of 45 blocks (15 subjects for each dosage) were performed. None of the volunteers
who received 1-mL of block had adequate anesthesia. Mean onset of anesthesia with
the 2-mL blocks was >6 minutes, whereas those of the 3-mL blocks took only 1.5 minutes.
The mean progression and duration of anesthesia were quicker and longer, respectively,
in the 3-mL blocks than the 2-mL ones. Pain associated with injection and discomfort
after injection in the 2- and 3-mL blocks was not different, but was significantly
higher than the 1-mL block.
Conclusions
The effectiveness of the 3-mL modified transthecal digital block is greater than the
1- and 2-mL blocks in terms of rapidity of onset, completeness, and duration of anesthesia.
Key words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Hand SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Transthecal digital block: flexor tendon sheath used for anesthetic infusion.J Hand Surg. 1990; 15A: 471-473
- Modified transthecal digital block.J Hand Surg. 1997; 22A: 361-363
- Comparison of transthecal digital block and traditional digital block for anesthesia of the finger.Ann Emerg Med. 1995; 5: 604-607
- Digital anaesthesia: comparison of the efficacy and pain associated with three digital nerve block techniques.J Hand Surg. 2005; 30B: 581-584
- Transthecal digital block.Arch Emerg Med. 1993; 10: 35-38
- Modified transthecal digital block versus traditional digital block for anesthesia of the finger.J Hand Surg. 2004; 29A: 44-48
- Transthecal digital block at the proximal phalanx.J Hand Surg. 2001; 26B: 69-71
- Tranthecal digital nerve block: an anatomic appraisal.J Hand Surg. 1998; 23B: 490-493
- Comparison of transthecal digital block and traditional digital block for anesthesia of the finger.Plast Reconstr Surg. 2004; 114: 1131-1134
Article info
Publication history
Accepted:
November 20,
2008
Received:
August 11,
2008
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2009 Published by Elsevier Inc.
