Hadzic's Regional Anesthesia > Part III. Clinical Practice of Regional Anesthesia > Section Five. Upper Extremity Nerve Blocks > Chapter 30. Digital Block Tagashige Iwata, MD, Louis Catalano, MD, Jerry D. Vloka, MD

Digital Block: Introduction

"Strauss¹ provided the first description of the digital block in 1889 for the condition of an ingrown toenail, using 20% cocaine at the base and under the nail. In 1905, Braun reported the synergistic advantage of adding epinephrine to local anesthetics.^2,3 However, the use of epinephrine in digital block anesthesia has been avoided due to the theoretical risk of ischemia and possible gangrene. More recently, however, Wilhelmi and colleagues⁴ demonstrated the safety and efficacy of epinephrine-containing local anesthetic for digital block, which made its use only more controversial. Digital block is one of the most common nerve block techniques, frequently used in the emergency department and primary care settings for various procedures such as lacerations of the finger or toe, nail removal, nail bed repair, paronychia drainage, removal of foreign bodies, and any other painful procedures on digits...."