Digital Block
Digital block is a safe and effective form of regional anesthesia. It is indicated for analgesia of laceration, fracture, infection or nail injury.
Complications include damage to digital vasculature or nerves.
The digital nerves run in the four corners of the finger. There are two methods of digital block:
- insert needle at 12 o’clock position and angle towards digital nerves, then at 6 o’clock and angle towards inferior digital nerves
- insert needle directly superior to lateral nerves and inject both nerves then repeat on medial nerves.
Neither method is superior, though the first method has less theoretical risk of vascular damage. Traditionally anasthetic preparations with epinephrine were avoided due to risk of digital ischemia. A recent literature review of 2800 cases of digital block concluded that epinephrine is safe to use in digital blocks as epinephrine-induced vasoconstriction rarely occurred, and was transient if present.
Resources/References
- Latham, J. and Martin, S. Infiltrative Anesthesia in Office Practice. Am Fam Physician. 2014 Jun 15;89(12):956-962.
Ilicki J. Safety of Epinephrine in Digital Nerve Blocks: A Literature Review. J Emerg Med. 2015 Nov;49(5):799-809. doi: 10.1016/j.jemermed.2015.05.038. Epub 2015 Aug 4. PMID: 26254284.
