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Subcutaneous single injection digital block with epinephrine
Motoki Sonohata1, Satomi Nagamine, Kazumasa Maeda
1Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga-shi, Saga 849-8501, Japan.
Anesthesiology Research and Practice
|August 9, 2011
Summary
Adding epinephrine to lidocaine for digital blocks significantly speeds anesthesia onset and extends its duration. This subcutaneous injection method proved safe, with no ischemic injury observed in healthy volunteers.
Area of Science:
- Anesthesiology
- Pharmacology
- Digital Nerve Blocks
Background:
- Digital nerve blocks are common procedures for hand and finger anesthesia.
- The use of epinephrine in digital blocks is debated due to concerns about ischemic complications.
Purpose of the Study:
- To evaluate the anesthetic efficacy and safety of a single subcutaneous injection digital block using lidocaine with epinephrine.
- To compare the onset and duration of anesthesia between lidocaine alone and lidocaine with epinephrine.
Main Methods:
- A randomized study involving 9 healthy volunteers and 18 middle fingers.
- Subcutaneous injection of either 3.0 mL of 1.0% lidocaine or 3.0 mL of 1.0% lidocaine with 1:100,000 epinephrine.
- Assessment of anesthetic effect, onset time, duration, and monitoring of SpO2 and for signs of ischemic injury.
Main Results:
- The epinephrine group showed a significantly shorter time to anesthesia (P < 0.05) and a significantly longer duration of anesthesia (P < 0.01).
- No subjects experienced ischemic injury, and SpO2 levels remained high (maximum decrease to 97%).
Conclusions:
- Subcutaneous single injection digital blocks with lidocaine and epinephrine are safe and effective.
- The addition of epinephrine enhances the anesthetic properties of lidocaine for digital blocks, reducing onset time and prolonging duration.
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