Anesthesia in the emergency setting: Part I. Hand and foot injuries.

Topical application and local infiltration of anesthetic agents are useful for localized areas, while a circular field block provides superficial anesthesia within the encircled area. Regional anesthesia is accomplished by injecting the anesthetic agent near a nerve or nerve group. Useful anesthetic techniques for repair of hand injuries include wrist blocks, intermetacarpal blocks and local infiltration anesthesia. Median nerve block, ulnar nerve block, radial nerve block or a combination of these blocks provides satisfactory anesthesia without inducing muscle paralysis in the anesthetized region. Intermetacarpal digital blocks are used to anesthetize any finger. Local infiltration is useful for closing minor lacerations. For foot injuries, the posterior ankle block is used to anesthetize the sole. The anterior ankle block is used for the dorsum of the foot.