Digital Block

Published on 16/03/2015 by admin

Filed under Orthopaedics

Last modified 16/03/2015

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Chapter 5 Digital Block

Overview

1. Two techniques can be used to perform a digital block:

a. Tendon sheath injection
b. Web space injection

2. The web space injection technique is more painful but provides a complete digital block more reliably.

Indications for use

A digital block is used for soft tissue injuries about the finger distal to the proximal interphalangeal joint.

Precautions

1. Warnings not to use epinephrine in a digit are based on misinterpretations of invalidated data.
2. Do not use a digital block if the metacarpophalangeal (MP) joint is surrounded by infection.

Pearls

When performing a tendon sheath injection, the dorsal block can be enhanced by skirting the tendon sheath on either side and injecting on the dorsum of the hand.

Equipment

1. Antiseptic: Chlorhexidine prep stick or alcohol-soaked gauze
2. Syringe: 10-mL syringe
3. Needle:

a. Large-bore, blunt-tipped, drawing-up needle
b. 1½-inch, 25-gauge needle

4. Anesthetic (for a typical adult):

a. Lidocaine: 5 mL of 2%
b. Bupivacaine: 5 mL of 0.5%

5. Sterile gloves
6. 4 × 4 inch gauze

Basic technique

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