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Local Anaesthetics (digital nerve block)

Discussion in 'Step I' started by drzzzzzzzz, Jan 12, 2018.

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  1. drzzzzzzzz

    drzzzzzzzz

    1
    0
    Jan 12, 2018
    A man, 27 years old, 45kg, undergoes a suture of finger. In this procedure, there is a need to administer a local anaesthesia for digital nerve block. What preparation should be used?

    1. 1.5% bupivacaine in 10mL

    2. 1.5% bupivacaine in 10mL with 1:200 000 adrenaline

    3. 2% lignocaine in 10mL

    4. 2% lignocaine in 10mL with 1: 200 000 adrenaline

    5. 2% lignocaine in 25mL
    Does anyone know what the answer is? As all of them seem to be over-dosed, and I am sure that #2 and #4 can't be answers to this question, as adrenaline should not be used in digital nerve block.

    Thanks
     
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  3. sahell

    sahell

    60
    22
    Nov 15, 2017
    I've not seen a single dose related question during my entire prep for STEP 1. From my clinical experience I would go with 3. Bupivacaine I've only used in spinal anaesthesia and adrenaline runs the risk of schema because the digital arteries are end arteries. I assume 3 is 2% lignocaine in 10mL saline which is a preparation I have used.
     
  4. operaman

    operaman Physician 7+ Year Member

    1,515
    2,977
    Jun 7, 2010
    It’s C. You’ll see variations of this question. The dosing isn’t what they’re testing. They’re testing whether you know the duration of action which steers toward lido for a short procedure. Then they’re testing whether you know the dangers of injection adrenaline aka epinephrine into distal extremities (penis nose fingers toes).
     

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