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The common digital nerves are branches of the median and ulnar nerves.
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The main digital nerves, accompanied by digital vessels, run on the ventrolateral aspect of the finger immediately lateral to the flexor tendon sheath. Small dorsal digital nerves run on the dorsolateral aspect of the finger and supply innervation to the back of the fingers as far as the PIP joint.
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Small procedures on the finger.
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Do not use epinephrine-containing local anesthetic.
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A 25G 1.5 in. needle is inserted at the base of the finger on the dorsolateral aspect, and directed anteriorly toward the base of the phalanx. The needle is advanced adjacent to the phalanx bone, while the operator observes the palmar skin for a protrusion due to the needle. After aspiration, 2–3 mL of local anesthetic is injected, and 2 more mL is injected continuously as the needle is withdrawn back to the skin. The same procedure is repeated on the other side of the finger.
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No motor block is achieved.
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Sensory block of the finger can be tested by pinching or pinprick.
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Complications/side effects:
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Avoid finger tourniquet. Do not use epinephrine-containing local anesthetic: risk of ischemia.
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Another technique is the transthecal block, where 2–3 mL of local anesthetic is injected into the flexor sheath. Success rate is reportedly high. However, there is a risk of infection of the flexor ...