Transthecal Metacarpal Block Versus Traditional Digital Block for Painful Finger Procedures in Children
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.
|Study Design:||Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Single Blind (Outcomes Assessor)
Primary Purpose: Treatment
|Official Title:||Transthecal Metacarpal Block vs Traditional Digital Block for Painful Finger Procedures in Children|
- Success of the two types of digital blocks [ Time Frame: immediate ]
- Pain experienced with the digital block [ Time Frame: immediate ]
- Repairing physician satisfaction with the procedure [ Time Frame: immediate ]
- complications associated with digital block [ Time Frame: 30 days ]
|Study Start Date:||July 2005|
|Study Completion Date:||August 2007|
randomized to receive the metacarpal block for anesthesia
|Procedure: Transthecal Metacarpal Block|
Background: Finger injuries and infections are common presenting problems in the pediatric emergency department. A traditional digital block, requiring at least two injections of anesthetic, is the traditional method of regional anesthesia for many finger procedures. Digital blocks can sometimes be difficult to administer and assess for effectiveness especially in children. A newer procedure, the transthecal metacarpal block, may be easier to administer, and more effective with one injection.
Objective: To determine if the transthecal metacarpal block (MCB) provides superior digit anesthesia in children requiring painful finger procedures as compared to the traditional digital block (TDB).
Methods: A randomized clinical trial comparing the MCB to the TDB will be conducted in an urban, tertiary care pediatric emergency department. Children <18 years of age, presenting to the emergency department with a finger injury or infection, which requires regional anesthesia for repair will be screened for eligibility. Eligible patients, with appropriate consent will be randomized to receive either the MCB or TDB with 1% Lidocaine. The primary outcome, success of the block will be assessed using pinprick testing after a standardized wait time. Secondary outcomes including pain with the block and repair, repairing physician satisfaction, and short-term complications will also be assessed.
Implications: Finding successful methods of anesthesia and pain control are paramount in the pediatric emergency department. In addition, using a type of digital block which is easy to administer, successful, and requires only one injection would give physicians confidence to treat finger injuries in children with regional anesthesia and possibly avoid procedural sedation in some cases. To date, no studies have been published on the efficacy of digital blocks in children. This study will also serve to give baseline success rates for both types of digital blocks.
|United States, Pennsylvania|
|The Children's Hospital Of Philadelphia Emergency Department|
|Philadelphia, Pennsylvania, United States, 19104|
|Principal Investigator:||Elizabeth R Alpern, MD, MSCE||The Children's Hospital of Philadelphia, Division of Emergency Medicine|