Nerve Block Methodology
Hello!
Not too long ago someone indicated that they had a different method than the usual volar/dorsal technique for a digital nerve block. Getting beyond the baggage of that thread, let's have a useful, positive, and open discussion.
My own experience was at the hands of a professional piercer and his assistant. The piercer has experience with implants, including digital magnets. He did not use the volar/dorsal or transthecal techniques, instead he injected lido with epi into the fingertips. I'll say that it was unpleasant, but I do think there were advantages to it. Having the block localized to the fingertip left me able to use the fingers to grip my steering wheel on my two-hour trip back home from the piercing parlour and the local use of epinephrine cut back bleeding dramatically (I think this is an advantage and disadvantage, it made his work easier, but you don't have the blood to help cleanse the wound). Overall, I like this method, but at the time it was disconcerting because I expected the volar/dorsal technique. I'd like to see some input from the resident experts, @Cassox in particular.
Not too long ago someone indicated that they had a different method than the usual volar/dorsal technique for a digital nerve block. Getting beyond the baggage of that thread, let's have a useful, positive, and open discussion.
My own experience was at the hands of a professional piercer and his assistant. The piercer has experience with implants, including digital magnets. He did not use the volar/dorsal or transthecal techniques, instead he injected lido with epi into the fingertips. I'll say that it was unpleasant, but I do think there were advantages to it. Having the block localized to the fingertip left me able to use the fingers to grip my steering wheel on my two-hour trip back home from the piercing parlour and the local use of epinephrine cut back bleeding dramatically (I think this is an advantage and disadvantage, it made his work easier, but you don't have the blood to help cleanse the wound). Overall, I like this method, but at the time it was disconcerting because I expected the volar/dorsal technique. I'd like to see some input from the resident experts, @Cassox in particular.
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Don't sweat it though... this doesn't mean it's bad. The closest thing to a criticism I'd apply to using local infiltration is that it lacks finesse.. and honestly I don't think the majority of people in this field give half a fuck about finesse. I often use local infiltration too along with a block if I'm working quickly. The onset is seriously quicker, but the duration is much shorter and the level of anesthesia decreased. I've found nerve blocks to require far less lido, last longer, and that people report far less pain.
I do however have to criticize the use of epinephrine. I get it, really. Vasoconstriction is nice. The proper use of a tourniquet achieves a bloodless field too, and without the added risk of infection, necrosis, cardiac side effects etc. Some physicians who specialize in plastic surgery of the hands for example do use epinephrine, but most don't. No one here is at a level of experience and education that they should feel free to buck the system in terms of standardized medical practices. Sure, there are even medical journal articles discussing how at times epinephrine can be really beneficial on peripheral regions such as the penis, nose, ears, and fingers. These journals weren't written for you though. Or for me for that matter. If people continue to use epinephrine, it's inevitable someone is going to lose a finger. I strongly advise against it. Usually, people aren't using lidocaine with epinephrine because they prefer it. It's usually a sourcing issue. This is laziness as far as I'm concerned and I wouldn't trust someone to cut me with such a cavalier attitude.
Short version: That's not a nerve block, but it's ok. Don't use epinephrine.
I'm no expert (obviously) and I don't want to be an alarmist, but it worries me that we never talk about this aspect of lidocaine injections.
Regarding sourcing lidocaine solution: There are many offshore sites that distribute lidocaine to individuals regardless of whether one has a prescription. I'm sure many bio-hackers are aware of this. I also tend to see quite a few questions about extracting lidocaine from OTC topical solutions.
My advice: avoid these options.
Offshore "pharmacies" tend to be, naturally, shady. Most Grey Market pharmaceutical distributors are. As such, you can never be sure of the quality of these products. Similarly, attempting to extract lidocaine, remove epinephrine, etc is likely to result in a product unsuitable for use, let alone internal use. Unless you have a strong background in chemistry or pharmacology (ppreferably both) and access to NMR or similar high-precision analytical equipment your best bet is to err on the side of caution and stick to reliable sources (such as DT).
That being said, if you insist on taking a DIY approach with anaesthetic, there are local sources for lidocaine hcl powder. I trust these sources far more than I trust offshore pharmacies, but even that is pushing it. Request lab results, and if they decline have a sample tested elsewhere or move on.