{"id":1345,"date":"2010-12-05T10:37:36","date_gmt":"2010-12-05T10:37:36","guid":{"rendered":"https:\/\/cloverock.info\/mockosce23\/new\/guided-anaesthesia-the-oberst-method\/"},"modified":"2023-11-15T10:24:50","modified_gmt":"2023-11-15T10:24:50","slug":"guided-anaesthesia-the-oberst-method","status":"publish","type":"post","link":"https:\/\/www.qpercom.com\/sim\/index.php\/minor-surgery\/skills\/guided-anaesthesia-the-oberst-method\/","title":{"rendered":"Guided Anaesthesia &#8211; The Oberst Method"},"content":{"rendered":"<hr \/>\n<h3><span style=\"color: #003366;\"><strong>Material<\/strong><\/span><\/h3>\n<ul>\n<li><span style=\"color: #003366;\">Syringes 2 ml and 5 ml.<\/span><\/li>\n<li><span style=\"color: #003366;\">Aspiration needle.<\/span><\/li>\n<li><span style=\"color: #003366;\">Fine needle.<\/span><\/li>\n<li><span style=\"color: #003366;\">Local anaesthetic without epinephrine (<em>lidocaine 1% or 2%<\/em>).<\/span><\/li>\n<li><span style=\"color: #003366;\">Disinfectants.<\/span><\/li>\n<li><span style=\"color: #003366;\">In medicine chest:<\/span>\n<ul>\n<li><span style=\"color: #003366;\">Tavegil\u00ae; 2 mg = 2 ml i.v.<\/span><\/li>\n<li><span style=\"color: #003366;\">Dexamethasone 5 ml = 1 ml i.v.<\/span><\/li>\n<li><span style=\"color: #003366;\">Epinephrine 1 mg = 1 ml, 0.3 ml i.m.<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<hr \/>\n<h3><span style=\"color: #003366;\">Procedure<\/span><\/h3>\n<ul>\n<li><span style=\"color: #003366;\">Ask the patient about allergies for iodine and\/or local anaesthetic.<\/span><\/li>\n<li><span style=\"color: #003366;\">Tell the patient what you are about to do.<\/span><\/li>\n<li><span style=\"color: #003366;\">Ask the patient to lie down.<\/span><\/li>\n<li><span style=\"color: #003366;\">Aspirate 2 ml of local anaesthetic (<em>if an assistant prepares the syringe, always check the bottle<\/em>).<\/span><\/li>\n<li><span style=\"color: #003366;\">Disinfect the area to be injected.<\/span><\/li>\n<li><span style=\"color: #003366;\">The point of entry for the fine needle is dorsal to one side of the phalanx base, distal to the <span style=\"color: #33cccc;\"><strong>metacarpophalangeal<\/strong><\/span> or <span style=\"color: #33cccc;\"><strong>metatarsophalangeal<\/strong><\/span> joint <em><strong>[Figure 12]<\/strong><\/em>.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-1343\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-12.jpg\" alt=\"\" width=\"400\" height=\"274\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-12.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-12-300x206.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><strong><span style=\"width: 400px; display: block;\">Figure 12<\/span><\/strong><\/span><\/p>\n<hr \/>\n<ul>\n<li><span style=\"color: #003366;\">The direction in which the needle is injected is from <span style=\"color: #33cccc;\"><strong>dorsal<\/strong><\/span> to <span style=\"color: #33cccc;\"><strong>palmar<\/strong><\/span> (<em>or plantar<\/em>).<\/span><\/li>\n<li><span style=\"color: #003366;\">Infiltrate by injecting about 0.5 ml towards the bone at the level of the dorsal sensory nerve branch <em><strong>[Figure 13-1]<\/strong><\/em>. <\/span><\/li>\n<li><span style=\"color: #003366;\">Inject slowly to ensure that no excessive tension in the tissue develops.<\/span><\/li>\n<li><span style=\"color: #003366;\">Insert the needle deeper in the volar direction and inject at the level of the volar sensory nerve branch again 0.5 ml of local anaesthetic (<em>the skin is unyielding here, so additional liquid causes high mechanical pressure; as a result, impaired circulation and pain can occur<\/em>)<em><strong> [Figure 13-2]<\/strong><\/em>.<\/span><\/li>\n<li><span style=\"color: #003366;\">Retract the needle to the point just under the skin.<\/span><\/li>\n<li><span style=\"color: #003366;\">Using the original point of entry, insert the needle dorsal to the phalanx, under the skin, over to the other side of the finger (<em>or toe<\/em>) and create a subcutaneous depot of 0.5 ml at the height of the subsequent second point of entry<\/span><br \/>\n<span style=\"color: #003366;\"><em><strong>[Figure 13-3]<\/strong><\/em>.<\/span><\/li>\n<li><span style=\"color: #003366;\">Anaesthetise according to steps 6-9 the dorsal and volar sensory nerve on the contralateral side of the phalanx <em><strong>[Figure 13-4, 13-5]<\/strong><\/em>.<\/span><\/li>\n<li><span style=\"color: #003366;\">Wait 5-10 minutes for the anaesthesia to take effect completely.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-1344\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-13.jpg\" alt=\"\" width=\"400\" height=\"277\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-13.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-13-300x208.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><strong><span style=\"width: 400px; display: block;\">Figure 13<\/span><\/strong><\/span><\/p>\n<hr \/>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Material Syringes 2 ml and 5 ml. Aspiration needle. Fine needle. Local anaesthetic without epinephrine (lidocaine 1% or 2%). Disinfectants. In medicine chest: Tavegil\u00ae; 2 mg = 2 ml i.v. Dexamethasone 5 ml = 1 ml i.v. Epinephrine 1 mg = 1 ml, 0.3 ml i.m. Procedure Ask the patient about allergies for iodine and\/or [&hellip;]<\/p>\n","protected":false},"author":83,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[76],"tags":[146],"class_list":["post-1345","post","type-post","status-publish","format-standard","hentry","category-skills","tag-minor-surgery"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Guided Anaesthesia - The Oberst Method - Qpercom | Skills in Medicine<\/title>\n<meta name=\"description\" content=\"Online Mock OSCEs with examiners, patient actors, instant results and personalised feedback. 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