Nail surgery: best way to obtain effective anesthesia

Nathaniel J Jellinek; Nicole F Vélez

doi:10.1016/j.det.2014.12.007

Nail surgery: best way to obtain effective anesthesia

Dermatol Clin. 2015 Apr;33(2):265-71. doi: 10.1016/j.det.2014.12.007. Epub 2015 Jan 29.

Authors

Nathaniel J Jellinek¹, Nicole F Vélez²

Affiliations

¹ Dermatology Professionals, Inc, 1672 South County Trail, East Greenwich, RI 02818, USA; Division of Dermatology, University of Massachusetts Medical School, Worcester, MA 01655, USA; Department of Dermatology, The Warren Alpert Medical School at Brown University, Providence, RI 02903, USA. Electronic address: winenut15@yahoo.com.
² Dermatology Professionals, Inc, 1672 South County Trail, East Greenwich, RI 02818, USA.

PMID: 25828716
DOI: 10.1016/j.det.2014.12.007

Abstract

Nail procedures require an effective and reliable approach to anesthesia of the distal digit. Several techniques have been described in the literature. Herein, the relevant anatomy of the nail unit, pain pathways, anesthetic options, and several injection approaches to achieve complete anesthesia are reviewed. Also considered are the potential pitfalls and complications and their management. Ultimately, the physician's approach must be individualized to the patient, procedure, and setting.

Keywords: Anesthesia complications; Anesthesia of the nail unit; Dermatologic surgery; Digital anesthesia; Nail biopsy; Nail surgery.

Publication types

Review
Video-Audio Media

MeSH terms

Anesthesia, Local / adverse effects
Anesthesia, Local / instrumentation
Anesthesia, Local / methods*
Anesthetics, Local / administration & dosage*
Biopsy
Epinephrine / administration & dosage
Humans
Nail Diseases / pathology*
Nail Diseases / surgery*
Nails / pathology*
Needles
Nerve Block / adverse effects
Nerve Block / instrumentation
Nerve Block / methods*
Pain / prevention & control
Temperature
Vasoconstrictor Agents / administration & dosage

Substances

Anesthetics, Local
Vasoconstrictor Agents
Epinephrine