Outcome of single injection volar subcutaneous block in hand surgery

Aim: to evaluate efficacy of single volar subcutaneous digital block in terms of onset and duration of anesthesia. methods: this descriptive study was conducted at plastic and reconstructive surgery department,hayatabad medical complex peshawar from dec. 2009 to dec. 2010. a total of 60 patients were included in the study. all patients had pathology distal to the first palmer digital crease like tumors,trauma,contracture,fractures etc. all the patients received the volar subcutaneous digital block. efficacy of digital block was measured in terms of time of onset of anesthesia,which was the total time duration after administering local anesthetic to loss of pinprick sensation and total duration of anesthesia,which was defined as the time period from onset of block (loss of pinprick sensation) till the appearance of pain which required additional local anesthetic or postoperative analgesia. results: a total of 60 patients were studied. of the total patients,45(75%) were male and 15(25%) were female with mean age of 27yrs (16-61). index finger was the most commonly involved finger as seen in 23(38.3%) patients,followed by ring finger in 20(33.3%) and long finger in 17(28.3%) of patients. the mean time of onset of anesthesia for volar single injection subcutaneous block from injection till the loss of pin prick sensation was 3.32±0.42 minutes and the mean total duration of anesthesia was 271.9±29.34 minutes for volar subcutaneous injection. conclusion: the volar subcutaneous single injection digital block is safe,efficient,and easy to perform with no danger of damaging the neurovascular bundle as might be happened with the dorsal injection block because of the proximity of the neurovascular bundles. it allows treatment of all conditions on volar aspect of the finger and on the dorsal aspect of the distal and middle phalanxes.