๐ ็ธฝ็ฎ้ ๏ฝ ๐ ่ฑๆๅๆ๏ผๆฌ็ฏ๏ผ ๏ฝ ๐ ๅฎๆด็ฟป่ญฏ ๏ฝ โญ ็ฒพ่ฏ็ญ่จ
Proximal Digital Block
Proximal Digital Block
Because the injection sites are far from the nail unit, a proximal digital block is an optimal approach when performing surgery on a painful distal nail, such as in the context of acute paronychia. It is of slower onset, and up to 20 minutes may be needed before complete numbing of the distal tip of the digit takes place. Unlike the distal digital block, it carries a potential risk for damage to the neurovascular bundles.8
Approximately 1 mL of anesthetic is injected laterally at the level of the metacarpophalangeal or metatarsophalangeal joints into each of the radial and ulnar (or the tibial and fibular) sides of the digit. Care should be taken to draw back on the syringe before injection to avoid injecting into an arteriole of the common digital artery (Fig. 34-3).
Figure 34-3. Dorsal hand arterial supply.