• Used in simple surgical procedures in the fingers and toes.

• It is also called ‘Ring Block’ as it forms like a ring anaesthesia

• The area distal to the ring block gets numb.

• The ‘Dorsal and Plantar nerves run in the sides of each finger.These are the ones that are targeted.

MEDICATIONS USED

• Lignocaine 1%

• Bupivacaine -0.5%

AMOUNT USED

• 1- 2 ml in each finger in elder children

• 0.5ml in each finger in younger children, based on size

• Before the procedure, check if the area is anaesthetized. You can inject more if insufficient anaesthesia

METHOD

• You can use 25G or 23G needle

• Keep the hand in a sterile area with palms facing downwards. Now inject the needle from the dorsum side, at the lateral side of the base of digit slightly inwards towards the midline of the digit.

• You can inject it until you feel the needle in the palmar skin surface. Make sure you don’t go through and through the skin.

• Always aspirate to make sure you are not injecting it into a blood vessel.

• Make sure you inject on both, the medial and lateral side of the finger.

When using it on the Big toe, you can inject it also at the base of big toe on the dorsal side along with the sides for more effective anaesthesia