[Single Subcutaneous Palmar Injection vs. 2 Dorsal Injections for Finger Anaesthesia in Hand Surgery - Randomised...

Area of Science:

• Emergency Medicine
• Anesthesiology
• Hand Surgery

Background:

• Local anesthesia is crucial for managing acute finger injuries in emergency settings.
• Traditional dorsal injection blocks can be painful and may require multiple attempts.
• Novel techniques aim to improve patient comfort and procedural efficiency.

Purpose of the Study:

• To compare the application pain and analgesic efficacy of the palmar subcutaneous single injection block (PSSIB) versus the traditional dorsal 2 injection block (DTIB).

Main Methods:

• A randomized prospective study included 190 patients with isolated finger injuries.
• Patients received either PSSIB or DTIB using 3ml of Mepicavaine 1%.
• Application pain was assessed using a Visual Analog Scale (VAS), and efficacy was evaluated 5 minutes post-injection.

Main Results:

• No significant difference in analgesic efficacy was observed between PSSIB and DTIB (p=0.096).
• PSSIB required fewer secondary injections compared to DTIB.
• Application pain was significantly lower for PSSIB (VAS 3.2) than for DTIB (VAS 4.0, p=0.002).

Conclusions:

• The palmar subcutaneous single injection block (PSSIB) provides reliable analgesia for finger injuries.
• PSSIB demonstrates significantly less application pain compared to the traditional dorsal 2 injection block (DTIB).
• PSSIB is a viable and more comfortable alternative for local anesthesia in finger injuries.