Comparison of Transthecal Digital Block and Traditional Digital Block for Anesthesia of the Finger, ,

Study objective: To compare the newly described transthecal (TT) and traditional (TD) methods of digital block anesthesia with regard to length of time to achieve anesthesia and pain during infiltration. Design: Prospective, randomized, controlled, blinded study. Participants: Healthy adult paid volunteers. Interventions: Each subject received a TT block on one hand and a TD block on the opposite hand. All blocks were performed by the same investigator and were rated by an evaluator who was blinded to the technique that was used. Time to loss of pinprick sensation was measured, and the pain of the procedure was recorded by the subject on a 10-cm visual-analog scale. Results: A total of 162 blocks (81 TT and 81 TD) were performed in 31 different subjects. All blocks were successful. Mean time to anesthesia for TT block was 188 seconds compared with 152 seconds for the TD block (P<.01). Mean analog pain score was slightly higher for TT block than for TD block (1.7 versus 1.4, P=.02). Conclusion: TT block is clinically equal to the TD method in terms of time to anesthesia and visual-analog pain score. [Hill RG Jr, Patterson JW, Parker JC, Bauer J, Wright E, Heller MB: Comparison of transthecal digital block and traditional digital block for anesthesia of the finger. Ann Emerg Med May 1995;25:604-607.]