Dorsal Digital Nerve Block vs. Ultrasound-Guided Selective Peripheral Nerve Block for Finger Analgesia: A Randomized Controlled Study.

BACKGROUND

Digital nerve block (DNB) is the most common nerve block for finger analgesia.

OBJECTIVE

This study compared the subjective discomfort and analgesic efficacy following DNB vs. ultrasound-guided selective peripheral nerve blocks (SPNBs) in the forearm in patients with finger injuries (FIs).

METHODS

This prospective randomized study was conducted at the emergency department (ED) of a tertiary care teaching institute. Adult patients of either gender presenting ED with FIs and having a numerical rating scale (NRS) pain score of >5 was provided with DNB or SPNBs for finger analgesia. The primary outcome measure was pain on injection (subjective discomfort) during DNB or SPNB. The secondary outcomes were analgesia onset, duration, block failure, need for rescue analgesia, and patient satisfaction on either arm.

RESULTS

In total, 106 patients with isolated FIs were enrolled in the study. The pain on injection (on NRS) of the first and second pricks was significantly lower in the SPNB group (1.98 ± 0.67 and 1.48 ± 0.65) than in the DNB group (3.5 ± 0.78 and 3.27 ± 0.85) (p ≤ 0.01, 95% CI [1.60, 2.58], and 95% CI [1.62, 2.66], respectively). Analgesia onset was significantly lower in the DNB group (178 ± 36 s) than in the SPNB group (264 ± 61 s) (p < 0.001). Analgesia duration was 11.34 ± 2.87 h and 18.64 ± 2.88 h (p < 0.001) in the DNB and SPNB groups.

CONCLUSION

Ultrasound-guided SPNBs are superior to dorsal DNBs in terms of subjective discomfort and analgesic efficacy in providing procedural analgesia for FIs.