Transthecal Metacarpal Block Versus Traditional Digital Block for Painful Finger Procedures in Children

NCT00130104 | Completed Phase 4

• 1 other identifier: 2005-5-4319
• Study Type: interventional
• Target: 92
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to determine if the transthecal metacarpal block is superior to the traditional digital block for regional digital anesthesia in children.

Conditions

Finger Injuries

Keywords

digital block; regional anesthesia; finger repair; Fingers; Anesthesia, Conduction

Outcome Measures

Primary Outcomes (1)

• Success of the two types of digital blocks

  immediate

Secondary Outcomes (3)

• Pain experienced with the digital block

  immediate

• Repairing physician satisfaction with the procedure

  immediate

• complications associated with digital block

  30 days

Study Arms (1)

MCB

EXPERIMENTAL

randomized to receive the metacarpal block for anesthesia

Procedure: Transthecal Metacarpal Block

Interventions

Transthecal Metacarpal Block PROCEDURE

MCB

Eligibility Criteria

• Age: Up to 18 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• Age \<18 years
• Greater than 10 kg in weight
• Have finger injuries or infections that will require digital regional anesthesia
• Require only local anesthesia for the repair
• English speaking

You may not qualify if:

• Have previous participation in this study
• Need procedural sedation at the onset of the repair
• Have allergy to lidocaine or amide-type local anesthetics
• Have infection at the sites of block injection
• Have known coagulopathy

Sponsors & Collaborators

• Children's Hospital of Philadelphia: lead
• University of Pennsylvania: collaborator

Study Sites (1)

The Children's Hospital Of Philadelphia Emergency Department

Philadelphia, Pennsylvania, 19104, United States

Location

Related Publications (16)

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  PMID: 8214828 BACKGROUND

• Kelly JJ, Spektor M. Nerve Blocks of the Thorax and Extremities. In:Roberts J, Hedges J, eds. Clinical Procedures in Emergency Medicine. St. Louis: WB Saunders, 2004.

  BACKGROUND

• Robson AK, Bloom PA. Suturing of digital lacerations: digital block or local infiltration? Ann R Coll Surg Engl. 1990 Nov;72(6):360-1.

  PMID: 2241053 BACKGROUND

• Flarity-Reed K. Methods of digital block. J Emerg Nurs. 2002 Aug;28(4):351-4. doi: 10.1067/men.2002.125539. No abstract available.

  PMID: 12122413 BACKGROUND

• Chiu DT. Transthecal digital block: flexor tendon sheath used for anesthetic infusion. J Hand Surg Am. 1990 May;15(3):471-7. doi: 10.1016/0363-5023(90)90063-w.

  PMID: 2348068 BACKGROUND

• Brutus JP, Baeten Y, Chahidi N, Kinnen L, Ledoux P, Moermans JP. Single injection digital block: comparison between three techniques. Chir Main. 2002 May;21(3):182-7. doi: 10.1016/s1297-3203(02)00107-5.

  PMID: 12116830 BACKGROUND

• Cummings AJ, Tisol WB, Meyer LE. Modified transthecal digital block versus traditional digital block for anesthesia of the finger. J Hand Surg Am. 2004 Jan;29(1):44-8. doi: 10.1016/j.jhsa.2003.09.018.

  PMID: 14751102 BACKGROUND

• Low CK, Vartany A, Engstrom JW, Poncelet A, Diao E. Comparison of transthecal and subcutaneous single-injection digital block techniques. J Hand Surg Am. 1997 Sep;22(5):901-5. doi: 10.1016/S0363-5023(97)80088-3.

  PMID: 9330152 BACKGROUND

• Morrison WG. Transthecal digital block. Arch Emerg Med. 1993 Mar;10(1):35-8. doi: 10.1136/emj.10.1.35.

  PMID: 8452611 BACKGROUND

• Torok PJ, Flinn SD, Shin AY. Transthecal digital block at the proximal phalanx. J Hand Surg Br. 2001 Feb;26(1):69-71. doi: 10.1054/jhsb.2000.0519.

  PMID: 11162023 BACKGROUND

• Hill RG Jr, Patterson JW, Parker JC, Bauer J, Wright E, Heller MB. Comparison of transthecal digital block and traditional digital block for anesthesia of the finger. Ann Emerg Med. 1995 May;25(5):604-7. doi: 10.1016/s0196-0644(95)70171-0.

  PMID: 7741335 BACKGROUND

• Hollander JE, Valentine SM, Brogan GX Jr. Academic associate program: integrating clinical emergency medicine research with undergraduate education. Acad Emerg Med. 1997 Mar;4(3):225-30. doi: 10.1111/j.1553-2712.1997.tb03747.x.

  PMID: 9063553 BACKGROUND

• Castellanos J, Ramirez C, De Sena L, Bertran C. Transthecal digital block: digital anaesthesia through the sheath of the flexor tendon. J Bone Joint Surg Br. 2000 Aug;82(6):889. doi: 10.1302/0301-620x.82b6.10430.

  PMID: 10990318 BACKGROUND

• Lewis L, Stephan M. Local and Regional Anesthesia. In: Henretig F, King C, eds. Pediatric Emergency Procedures. Baltimore: Williams and Wilkins, 1997.

  BACKGROUND

• Carlson D, et al. Illustrated Techniques of Pediatric Emergency Procedures. In: Fleisher G, Ludwig S, eds. Pediatric Emergency Medicine. Philadelphia: Williams and Wilkins, 2000.

  BACKGROUND

• Antevy PM, Zuckerbraun NS, Saladino RA, Pitetti RD. Evaluation of a transthecal digital nerve block in the injured pediatric patient. Pediatr Emerg Care. 2010 Mar;26(3):177-80. doi: 10.1097/PEC.0b013e3181d1dfaf.

  PMID: 20179662 BACKGROUND

MeSH Terms

Conditions

Finger Injuries

Condition Hierarchy (Ancestors)

Hand Injuries; Wounds and Injuries

Study Officials

• Elizabeth R Alpern, MD, MSCE

  The Children's Hospital of Philadelphia, Division of Emergency Medicine

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 4
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER

Study Record Dates

• First Submitted: August 11, 2005
• First Posted: August 15, 2005
• Study Start: July 1, 2005
• Study Completion: August 1, 2007
• Last Updated: October 5, 2007

Record last verified: 2005-08

Locations

US (1)