Digital Nerve Blocks: A Comprehensive Review of Techniques

J Emerg Med. 2022 Oct;63(4):533-540. doi: 10.1016/j.jemermed.2022.07.002. Epub 2022 Oct 11.


Background: Finger and toe injuries are a common reason for presentation to the emergency department. In order to properly care for these injuries, it is valuable for emergency medicine clinicians to be aware of the different approaches to anesthetize the digit.

Methods: We searched the literature using PubMed to determine the different techniques and supporting data for digital nerve blockades.

Discussion: The primary digital nerve block techniques include the dorsal web space block, transthecal block, volar subcutaneous block, and the circumferential (three-sided and four-sided) ring block. Success rates range from 60% to 100%. There are unique advantages and limitations of each block that are important to consider.

Conclusions: There are a number of options at the disposal of the emergency medicine clinician for anesthesia of the finger and toe. This article summarizes the key techniques, variations on these techniques, advantages, and disadvantages for each approach.

Keywords: Nerve block; digital block; dorsal web space block; ring block; subcutaneous block; transthecal block; volar.

Publication types

  • Review

MeSH terms

  • Anesthetics, Local / therapeutic use
  • Emergency Medicine*
  • Fingers
  • Humans
  • Injections, Subcutaneous
  • Nerve Block* / methods


  • Anesthetics, Local