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What are the top tips for achieving anaesthesia when doing a hallucal H-block for nail surgery?

 

Re: Nail suery

In order to perform a successful H block every time you attempt nail suery, I recommend reading the following link:
http://www.prisoner-cellblockh.co.uk/oti.html

I personally prefer a digital block for performing nail surgery. My top tips for this are:

- select the correct toe you wish to anaesthetise
- select the correct local anaesthetic
- deposit the correct local anaesthetic in the correct toe near to the digital nerves of said toe
- wait until it works
- perform the surgery
- go for lunch
- eat lunch

 

I use 1% Xylocaine instead of 2%. It works just as well but has the benefit of being able to inject twice as much if required or if working on mulitple nails.

 

I use 3% Mepivicaine (Scandonest) plain. Max 4.4 mls /toe. I generally use about half that. Toe normally goes off in less than 5 minutes especially if you drop the foot rest and gently massage the toe. Test with neurotip for sensation and off you go.

Normally the toe is 'dead for around 2-3 hours and not just the 60-90 minutes that the text says.

Nick

 

Do it properly, and do not invoke vocal anasthesia. Try to remember that nail surgery is not a specialist technique - it is routine podiatry. The day it becomes a specialsit area, I will specialise in left feet, and cease to treat those on the right.

 

I thought you already did that Bob! Silly me!!! ;)

 

Actually Paul, my speciality is to treat dead feet - but you know that already!

 

Warm the ampoule in your bra for an hour or two before injecting, genuinely causes less pain to the patient as the anaesthetic is at body temperature. (somewhere similar for men) !

 

Elizabeth - I am presently looking for an assocoate/assistant and use local analgesia several times daily. Are you available/interested?

 

Oh dear, I had a horrible feeling that might happen . .

 

Tsk!

Mr Russell,

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