A COMPARATIVE STUDY OF ANESTHETIC BLOCK TECHNIQUES (V-BLOCK VS. H-BLOCK) FOR REMOVAL OF INGROWN TOENAIL
DOI:
https://doi.org/10.54112/bcsrj.v2024i1.959Keywords:
anesthesia, V-block, H-block, toe nailAbstract
Ingrown toenail (onychocryptosis) is a common and painful condition often requiring surgical intervention. Adequate local anaesthesia is crucial for patient comfort and surgical success. However, the optimal anaesthetic technique for this procedure remains debated. Objectives: This study aimed to evaluate and compare the anaesthetic efficacy, patient comfort, onset and duration of anaesthesia, and occurrence of complications between the V-block and H-block techniques during surgical procedures for ingrown toenail removal. Methods: After ethical approval, an open-label randomised control trial was conducted at Ruth PFAU Civil Hospital, Dow University of Health Sciences, Karachi. One hundred eighty-eight patients, aged 18 and above, with type II, III, and IV onychocryptosis were included. Patients were randomly assigned to either Group A (H-technique, n=94) or Group B (V-technique, n=94). Local anaesthesia was administered using 5 ml of 2% Xylocaine diluted in 5 ml of distilled water. Pain severity, numbness, and loss of sensation were assessed at 2, 5, and 10 minutes post-injection. Data were analysed using SPSS version 26. Results: Group A (H-technique) had a significantly younger average age (35.12±9.8 years) compared to Group B (39.77±13.01 years). Gender distribution differed significantly, but weight did not. At 2 minutes, Group B reported more pain (90% vs. 86.5%, P=0.045). At 5 and 10 minutes, Group B showed higher numbness and loss of sensation, indicating more comprehensive anaesthesia. Efficacy at 10 minutes was higher in Group B (44% vs. 39%, P=0.045), with similar trends at 20 minutes but no significant difference. Conclusion: The V-block technique offers rapid onset and effective pain relief for routine procedures, while the H-block technique provides more comprehensive and sustained anaesthesia for complex surgeries. The selection of anaesthetic techniques should be based on the surgical context to optimise patient outcomes. Further research is recommended to enhance these techniques' efficacy and minimise complications.
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References
Pawlik P, Zaroda P, Dąda P, Niewinna P, Żuchowski M, Mańdziuk D, et al. Onychocryptosis: A review of epidemiology, risk factors, classification, complications and effective therapeutic strategies. Journal of Education, Health and Sport. 2024;55:199-216.
Şenol Z, Gülşen T. A new, quick, effective and minimally invasive treatment technique applied to ingrown toenails. The European Research Journal. 2022;8(3):383-8.
Mayeaux Jr E, Carter C, Murphy TE. Ingrown toenail management. American family physician. 2019;100(3):158-64.
Thakur V, Vinay K, Haneke E. Onychocryptosis–decrypting the controversies. International Journal of Dermatology. 2020;59(6):656-69.
Ranganath A, Ahmed O, Iohom G. Effects of local anaesthetic dilution on the characteristics of ultrasound guided axillary brachial plexus block: a randomised controlled study. Medical Ultrasonography. 2022;24(1):38-43.
Phuphanich ME, Convery QW, Nanda U, Pangarkar S. Sympathetic blocks for sympathetic pain. Physical Medicine and Rehabilitation Clinics. 2022;33(2):455-74.
Exley V, Jones K, O'Carroll G, Watson J, Backhouse M. A systematic review and meta‐analysis of randomised controlled trials on surgical treatments for ingrown toenails part I: recurrence and relief of symptoms. Journal of foot and ankle research. 2023;16(1):35.
Asma Ghafoor IV O, Paracha H, Goldstein Z. Ingrown Toenail Management. Osteopathic Family Physician. 2021;13(3):31-4.
Giralt de Veciana E. Comparison of 2 Anesthetic Techniques in Onychocryptosis Surgery of the Great Toe: A Randomized Clinical Trial. Actas Dermo-sifiliograficas. 2021;113(4):370-5.
Chen Y, Xu J, Li P, Shi L, Zhang S, Guo Q, et al. Advances in the use of local anesthetic extended-release systems in pain management. Drug Delivery. 2024;31(1):2296349.
Flaviano E, Bettinelli S, Assandri M, Muhammad H, Benigni A, Cappelleri G, et al. Erector spinae plane versus fascia iliaca block after total hip arthroplasty: a randomized clinical trial comparing analgesic effectiveness and motor block. Korean Journal of Anesthesiology. 2023;76(4):326-35.
Sánchez S, de Veciana EG. Bloqueo digital anestésico con técnica V versus técnica H en onicocriptosis infectadas del primer dedo del pie.: Eficacia Técnica en V. REVISTA IBERO-AMERICANA DE PODOLOGIA. 2020;2(2):190-5.
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