Local Anaesthetics (digital nerve block)

[drzzzzzzzz]

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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[sahell]

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.

 

[operaman]

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).