title: [Single Subcutaneous Palmar Injection vs. 2 Dorsal Injections for Finger Anaesthesia in Hand Surgery - Randomised Prospective Comparison of Application Pain and Efficacy].
abstract: OBJECTIVE
  This randomised prospective study compared pain during application and efficacy of the palmar subcutaneous single injection block (PSSIB) and the traditional dorsal 2 injection block (DTIB).
  
  
  METHODS
  During a 2 year period, a total of 190 patients with an average age of 43 years (18-82) and an isolated finger injury were included in the study. The injection was applied by residents (n=29) of the emergency department. 96 patients received PSSIB (72 men, 24 women) and 94 DTIB (55 men, 39 women) with 3 ml of Mepicavain(®) 1%. Randomisation was performed by even/odd hospital admission number.
  
  
  METHODS
  Thumb injury, progressive infection with visible redness at injection point. Application pain was recorded immediately after injection and registered on a VAS (0-10). Efficacy was checked 5 min after application. The patients quoted the efficacy as complete pain-free, almost pain-free and inadequate anesthesia (second injection was necessary). Statistical analysis was performed using the chi-quadrat and the t test; the level of significance was set at p<0.05.
  
  
  RESULTS
  There was no significant difference in terms of analgesic efficacy (p=0,096), while the PSSIB required fewer second injections. Application pain was rated as being significantly (p=0.002) less painful for PSSIB (3.2) than for DTIB (4,0).
  
  
  CONCLUSIONS
  This study shows that PSSIB gives reliable analgesia and the application pain is significant less than during DTIB.
authors: Hirslanden Klinik Birshof, LEONARDO - Ärzte für Orthopädie und Traumatologie, Handzentrum, Münchenstein, Schweiz.
authors: N
authors: N
authors: Schelhorn
authors: Kantonsspital Baselland Standort Bruderholz, Chirurgie, Bruderholz, Schweiz.
authors: S
authors: S
authors: Lamm
authors: Hirslanden Klinik Birshof, LEONARDO - Ärzte für Orthopädie und Traumatologie, Handzentrum, Münchenstein, Schweiz.
authors: R
authors: R
authors: Fricker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D006225:Hand / Q000601:surgery*; D006801:Humans; D007267:Injections; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D010146:Pain; D010147:Pain Measurement; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local