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Comparison of transthecal and subcutaneous single-injection digital block techniques
C K Low1, A Vartany, J W Engstrom
1Department of Orthopaedic Surgery, University of California, San Francisco, USA.
The Journal of Hand Surgery
|October 23, 1997
Summary
The single-injection subcutaneous digital block technique is easier and less painful than the transthecal method for digital anesthesia. Both techniques demonstrated similar effects on anesthesia distribution, onset, duration, and nerve conduction.
Area of Science:
- Anesthesiology
- Neurosurgery
- Orthopedic Surgery
Background:
- Digital anesthesia is crucial for hand and finger surgeries.
- Comparing different single-injection techniques is essential for optimizing patient comfort and procedural efficiency.
Purpose of the Study:
- To compare the efficacy and patient experience of single-injection transthecal versus subcutaneous digital block techniques.
- To evaluate the impact of each technique on sensory nerve function and anesthesia characteristics.
Main Methods:
- A randomized, double-blinded study involving 20 healthy volunteers.
- Each volunteer received both transthecal and subcutaneous digital blocks on separate index fingers.
- Pain, light touch, and sensory nerve conduction studies (median and radial nerves) were assessed before and at 10-minute intervals post-injection until recovery.
Main Results:
- No significant differences were observed in the distribution, onset, or duration of anesthesia between the two techniques.
- Reductions in sensory nerve action potential amplitude were comparable for both methods.
- The subcutaneous technique was rated as easier to administer and caused less pain during and 24 hours after injection compared to the transthecal technique.
Conclusions:
- Single-injection subcutaneous digital block offers a simpler and more comfortable alternative to the transthecal technique.
- Both methods provide effective digital anesthesia with similar electrophysiological outcomes.
- The choice of technique may be guided by ease of administration and patient-reported pain levels.