A Comparison of Traditional Digital Blocks and Single Subcutaneous Palmar Injection Blocks at the Base of the Finger and a Meta-analysis of the Digital Block Trials

Author(s): Yin ZG, Zhang JB, Kan SL, Wang P

Source: J Hand Surg 31B:547-555, 2006.


The authors compared traditional digital block anesthesia with single subcutaneous palmar injection block anesthesia in a randomized and controlled trial.  There were no differences in time to anesthesia or injection site pain.  A concurrent meta-analysis of published controlled trials revealed that palmar injection techniques carried a risk of not adequately anesthetizing the dorsum of the digit.

A palmar subcutaneous injection block theoretically avoids injury to the radial and ulnar digital nerves.  The needle is directed mid-line, in between the neurovascular bundles.  However, dorsal sensory nerve branches variably innervate the dorsum of the finger (Bas and Kleinert, JHS Am, 1999).  If inadequate anesthesia is achieved with a palmar subcutaneous digital block, additional infiltration of anesthetic into the subcutaneous tissue at the dorsal base of the digit may provide benefit.   


Digital, Block, Anesthesia

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J Hand Surg