Colonel Block

When Colonel block or Oberst-anesthesia refers to a regional anesthesia of the finger , which is smaller in wound supply or removal of skin tumors is used. The process was described by Maximilian Oberst in 1888 . In principle, the Oberst-Block can also be used analogously for surgical interventions on the toes.

execution

The metacarpophalangeal joints after disinfection with a thin cannula to both the two palm Windwärts (be on the base of the fingers in the amount palmar ) and to the back of the hand back ( dorsal ) located pairs of nerves ( nerve palmar digital proprius , nerve digitalis dorsalis proprius ) several milliliters of local anesthetic injected. By switching off these four nerves, the finger is completely numb after about five to ten minutes.

Side effects

The complications correspond to the general side effects of peripheral regional anesthesia. Nerve damage can be caused by direct cannula injury or by toxic effects of local anesthetics that are accidentally injected into the nerves (intraneurally) . The addition of adrenaline to the local anesthetic is forbidden because end arteries run in the finger . Injection into this, especially with the addition of adrenaline, can lead to circulatory disorders up to and including death of the finger.

literature

• Klaus-Peter Schmit-Neuerburg, Rainer Letsch, Hossein Towligh: elbow, forearm, hand ( Tscherne trauma surgery , volume 5). Springer, Berlin 2001, ISBN 978-3-540-63300-6 , pp. 298f.

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