E. Chevaleraud et al., LOCAL-ANESTHESIA OF THE FINGER USING THE FLEXOR TENDON SHEATH, Annales francaises d'anesthesie et de reanimation, 12(3), 1993, pp. 237-240
A series a 350 cases of local anaesthesia of the ringer using the flex
or tendon sheath is reported. The patients were ranked ASA 1 or 2 and
the youngest was 12 months old. This technique was used for day case s
urgery, such as nail trauma and tumours, wound exploration, tumour and
cyst removal, tenolysis and neurolysis. The needle was inserted on th
e palmar aspect of the metacarpophalangeal joint, into the digital fle
xor tendon of the corresponding finger. Thereafter the needle was with
drawn very slightly in order to inject the local anaesthesia solution
within the sheath, and not the tendon. The volumes were respectively 1
ml in children and 3 to 4 ml in adults of either 2 % lignocaine or 0.
5 % bupivacaine without adrenaline. As palmar injections are painful a
freezing spray solution was used prior to insertion of the needle. Th
ere was no anaesthesia of the dorsal digital nerves, as opposed to the
findings of the author of the first series. This technique, which can
be qualified as being easy and reliable, could be a valuable alternat
ive for the ring or interdigital blocks, which carry a significant ris
k of vascular and neurological complications.