DIGITAL BLOCK APPLICATIONS; A DETAILED SURVEY BETWEEN SURGICAL BRANCH SPECIALIST AND SPECIALIST STUDENTS
DOI:
https://doi.org/10.29121/granthaalayah.v13.i1.2025.5867Keywords:
Digital Block, Guide, SurveyAbstract [English]
Purpose: The purpose of this study was to investigate the digital block application methods of specialists and assistants working in the Departments of Orthopedics and Traumatology, Emergency Medicine, Anesthesia and Reanimation, and Plastic and Reconstructive Surgery in Turkey and the accuracy of the information on which these methods are based, through a survey, and to interpret the survey results.
Study plan: In the survey consisting of a total of eighteen questions, the personal information of the physicians, their preferred digital block application methods, local anesthetic agent selection and application doses, and the source of the information on which these preferences are based were questioned in a digital environment. The responses were interpreted and analyzed.
Findings: A total of 110 physicians, 16 specialists and 94 assistants, participated in our survey. In the responses given to the multiple-choice question asked to the participants about the cases you encounter most frequently in your clinic, we saw that the most common ones were fractures at the finger and toe level, skin and subcutaneous lacerations at the finger level, and tendon injuries. In the responses we received to the question of the most preferred type of anesthesia in such injuries, we saw that 51.9% preferred digital block and 42.6% preferred regional anesthesia. In the responses we received to other questions regarding the application method, dosage and different usage patterns in our survey, it was seen that traditional and personal experiences were effective in digital block applications.
Conclusion: It was determined that the digital nerve block applications preferred by specialists and specialist students were not compatible with the literature. The results of the study are warning signs for the revision of digital block applications. Experience-based applications and personal teachings should be replaced by evidence-based applications in digital block applications.
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Altınyazar, H. C., Ozdemir, H., Koca, R., & Demirci, M. (2004). Epinephrine in Digital Block: Color Doppler Flow Imaging. Dermatologic Surgery, 30(4), 508-511. https://doi.org/10.1097/00042728-200404000-00008
American Academy of Pediatrics, & American Academy of Pediatric Dentistry; Cote, C. J., Wilson, S., & Sedation Working Group. (2006). Guidelines for Monitoring and Management of Pediatric Patients During and After Sedation for Diagnostic and Therapeutic Procedures: An update. Pediatrics, 118(6), 2587-2602. https://doi.org/10.1542/peds.2006-2780
Antevy, P. M., Zuckerbraun, N. S., Saladino, R. A., & Pitetti, R. D. (2010). Evaluation of a Transthecal Digital Nerve Block in the Injured Pediatric Patient. Pediatric Emergency Care, 26(3), 177-180. https://doi.org/10.1097/PEC.0b013e3181d1eae1
Bartfield, J. M., Ford, D. T., & Homer, P. J. (1993). Buffered Versus Plain Lidocaine for Digital Nerve Blocks. Annals of Emergency Medicine, 22(2), 216-219. https://doi.org/10.1016/S0196-0644(05)80206-9
Cannon, B., Chan, L., Rowlinson, J. S., & Little, M. (2010). Digital Anaesthesia: One Injection or two? Emergency Medicine Journal, 27(7), 533-536. https://doi.org/10.1136/emj.2009.081349
Chow, M. Y. H., Sia, A. T. H., Koay, C. K., & Chan, Y. W. (1998). Alkalization of Lidocaine Does not Hasten the Onset of Axillary Brachial Plexus Block. Anesthesia & Analgesia, 86(3), 566-568. https://doi.org/10.1097/00000539-199803000-00024
Cornelius, P., Kendall, J., Meek, S., & Rajan, R. (1996). Alkalinisation of Lignocaine to Reduce the Pain of Digital Nerve Blockade. Journal of Accident & Emergency Medicine, 13(5), 339-341. https://doi.org/10.1136/emj.13.5.339
Dadure, C., Sola, C., Dalens, B., & Capdevila, X. (2015). Concomitant Anesthesia in Children. In R. D. Miller (Ed.), Miller's Anesthesia (8th ed., 2718). Elsevier.
De Buck, F., Devroe, S., Missant, C., & Van de Velde, M. (2012). Regional Anesthesia Outside the Operating Room: Indications and Techniques. Current Opinion in Anaesthesiology, 25(4), 501-507. https://doi.org/10.1097/ACO.0b013e3283556f58
Gitman, M., & Barrington, M. J. (2018). Local Anesthetic Systemic Toxicity: A Review of Recent Case Reports and Registries. Regional Anesthesia and Pain Medicine, 43(2), 124-130. https://doi.org/10.1097/AAP.0000000000000720
Hill, R. G. Jr., Patterson, J. W., Parker, J. C., & McKay, P. L. (1995). Comparison of Transthecal Digital Block and Traditional Digital Block for Anesthesia of the Finger. Annals of Emergency Medicine, 25(5), 604-607. https://doi.org/10.1016/S0196-0644(95)70171-0
Keramidas, E. G., Rodopoulou, S. G., Tsoutsos, D., & Koullias, N. (2004). Comparison of Transthecal Digital Block and Traditional Digital Block for Anesthesia of the Finger. Plastic and Reconstructive Surgery, 114(4), 1131-1134. https://doi.org/10.1097/01.PRS.0000135848.60764.AE
Knoop, K., Trott, A., & Syverud, S. (1994). Comparison of Digital Versus Metacarpal Blocks for Repair of Finger Injuries. Annals of Emergency Medicine, 23(6), 1296-1300. https://doi.org/10.1016/S0196-0644(94)70355-8
Mantilla-Rivas, E., Tan, P., Zajac, J., Tilt, A., Rogers, G. F., & Oh, A. K. (2019). Is Epinephrine Safe for Infant Digit Excision? A Retrospective Review of 402 Polydactyly Excisions in Patients Younger than 6 Months. Plastic and Reconstructive Surgery, 144(1), 126e-133e. https://doi.org/10.1097/PRS.0000000000005774
Morrison, W. G. (1993). Transthecal Digital Block. Archives of Emergency Medicine, 10(1), 35. https://doi.org/10.1136/emj.10.1.35
Okur, O. M., Şener, A., Kavaklı, H. Ş., Genç, S., & Kunt, M. M. (2017). Two Injection Digital Block Versus Single Subcutaneous Palmar Injection Block for Finger Lacerations. European Journal of Trauma and Emergency Surgery, 43(6), 863-868. https://doi.org/10.1007/s00068-016-0695-7
Pere, P. J., Ekstrand, A., Salonen, M., Mäkinen, K., & Rosenberg, P. H. (2011). Pharmacokinetics of Ropivacaine in Patients with Chronic Renal Failure. British Journal of Anaesthesia, 106(4), 512-521. https://doi.org/10.1093/bja/aer026
Pere, P., Salonen, M., Jokinen, M., Rosenberg, P. H., Neuvonen, P. J., & Haasio, J. (2003). Pharmacokinetics of Ropivacaine in Uremic and Nonuremic Patients After Axillary Brachial Plexus Block. Anesthesia & Analgesia, 96(2), 563-569. https://doi.org/10.1213/00000539-200302000-00047
Rosenberg, P. H., Veering, B. T., & Urmey, W. F. (2004). Maximum Recommended doses of Local Anesthetics: A Multifactorial Concept. Regional Anesthesia and Pain Medicine, 29(6), 564-575 https://doi.org/10.1097/00115550-200411000-00010
Silva Neto, O. B. D., Costa, C. F. P. A., Veloso, F. S., Kassar, S. B., & Sampaio, D. L. (2020). Effects of vasoconstrictor use on Digital Nerve Block: Systematic Review with Meta-Analysis. Revista do Colégio Brasileiro de Cirurgiões, 47, e20202346. https://doi.org/10.1590/0100-6991e-20202346
Sonohata, M., Asami, A., Ogawa, K., Kurimoto, S., & Mawatari, M. (2009). Single Injection Digital Block: Is Transthecal Injection Necessary? Journal of Hand Surgery (European Volume), 34(1), 94-95. https://doi.org/10.1177/1753193408096019
Waldbillig, D. K., Quinn, J. V., Stiell, I. G., & Wells, G. A. (1995). Randomized Double-Blind Controlled trial Comparing Room-Temperature and Heated Lidocaine for Digital Nerve Block. Annals of Emergency Medicine, 26(6), 677-681. https://doi.org/10.1016/S0196-0644(95)70036-6
Zahl, K., Jordan, A., McGroarty, J., Sorensen, B., & Gotta, A. W. (1991). The Effect of Bicarbonate on Mixtures of Lidocaine, Bupivacaine and Hyaluronidase with or without Epinephrine. Ophthalmology, 98(2), 239-242. https://doi.org/10.1016/S0161-6420(91)32311-X
Zilinsky, I., Bar-Meir, E., Zaslansky, R., Winkler, E., & Dannon, P. (2005). Ten Commandments for Minimal Pain During Administration of Local Anesthetics. Journal of Drugs in Dermatology, 4(2), 212-216.
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