Evaluation of transthecal block and traditional digital block in cancer patients with nail toxicity

Authors

Keywords:

anesthesia and analgesia, anesthetics local, drug therapy, nerve block, nail diseases

Abstract

Introduction: taxanes are the drugs most implicated in the production of nail toxicity. Nail lesions in cancer patients are a reason for consultation for surgical treatment with local anesthesia.
Objective: to evaluate transthecal block and traditional digital block in cancer patients with nail toxicity.
Methods: a quasi-experimental study was conducted in the Podiatry Clinic of the "Maria Curie" Provincial Teaching Oncology Hospital from February 2022 to February 2023. The sample consisted of 165 patients who met the inclusion and exclusion criteria. A simple random sample of 60 patients was selected, divided into two groups of 30 patients each: the experimental group, operated on with transthecal block anesthesia, and the conventional group, operated on with traditional digital block anesthesia.
Results: the mean age was 55.35 years, and the hand was the site of 78.3% of surgical nail toxicity. Sex, age, and the affected anatomical area did not influence the efficacy of the anesthetic procedure, according to statistical tests and the homogeneity of the groups. The comparison between the variables of intraoperative pain and preoperative pain (p<0.000) confirmed that transthecal and traditional digital blocks ensure sufficient anesthesia for the surgical procedure, with 66.7% of cases being pain-free during the intraoperative period.
Conclusions: transthecal and traditional digital blocks were effective in cancer patients by reducing the negative impact of nail toxicity.

 

Downloads

Download data is not yet available.

Author Biographies

Zunamys Raquel Silveira Cuellar, University of Medical Sciences of Camagüey

Specialist in Comprehensive General Medicine and Specialist in Bachelor of Health Technology. Faculty of Technology

Zaily Fuentes Díaz, “María Curie” Provincial Teaching Oncology Hospital, Camagüey. Cuba

Anesthesiology and Resuscitation. Full Professor. Research Assistant. Anesthesiology and Resuscitation Service.

Orlando Bismark Rodríguez Salazar, Manuel Ascunce Domenech University Hospital, Camagüey, Cuba

Master's Degree in Emergency Medicine. First-Level Specialist in Comprehensive General Medicine and Second-Level Specialist in Plastic Surgery and Caumatology. Assistant Professor. Research Associate. Plastic Surgery and Caumatology Service.

Tania Puerto Pérez, University of Medical Sciences of Camagüey

First-degree specialist in biostatistics. Assistant professor.

References

1. Lao DH, Chen Y, Fan J, Zhang JZ. Evaluación de eventos adversos asociados a taxanos utilizando la base de datos del sistema de notificación de eventos adversos de la FDA. Chin Med J (Engl) [Internet]. 2021 [citado 26/03/2023]; 134(12): [aprox. 3p.] Disponible en:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8213312/?report=reader

2. Mittal S, Khunger N, Kataria SP. Cambios en las uñas con agentes quimioterapéuticos y terapias dirigidas. Indian Dermatol Online J [Internet]. 2022 [citado 26/03/2023]; 13(1): [aprox. 3p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8809183/

https://doi.org/10.4103/idoj.IDOJ_801_20

3. Espinosa ML, Abad C, Kurtzman Y, Abdulla FR. Toxicidades dermatológicas de la terapia dirigida y la inmunoterapia en los cánceres de cabeza y cuello. Front Oncol [Internet]. 2021 [citado: 20/03/2023]; 11:[aprox. 2p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8190330/

https://doi.org/10.3389/fonc.2021.605941

4. Morrison A, Marshall-McKenna R, McFadyen AK, Hutchison C, Rice AM, Stirling L, et al. Un ensayo controlado aleatorio de intervenciones para la toxicidad de las uñas inducida por taxanos en mujeres con cáncer de mama temprano. Sci Rep [Internet]. 2022 [citado: 20/03/2023]; 12(1):[aprox. 3p.]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/35798751/

https://doi.org/10.1038/s41598-022-13327-6

5. Emvalomati A, Oflidou V, Papageorgiou C, Kemanetzi C, Giannouli M, Kalloniati E, et al. Revisión narrativa de toxicidades de uñas asociadas a fármacos en pacientes oncológicos. Dermatol Pract Concept [internet]. 2023 [citado: 20/03/2023]; 13(1):e2023064. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9946059/

https://doi.org/10.5826/dpc.1301a64

6. Rabasco Pérez J. Toxicidad ungueal en pacientes oncológicos: ¿qué puede ofrecer el podólogo a estos pacientes? Análisis de una muestra de 51 pacientes [Tesis]. Elche: Universidad Miguel Hernández. Facultad de Medicina; 2019. Disponible en: https://dspace.umh.es/bitstream/11000/6720/1/939_RABASCO_P%C3%89REZ_JES%C3%9AS.pdf

7. Jarragh A, Lari A, Burhamah W, Alherz M, Nouri A, Alshammari Y, et al. Comparación del dolor y la extensión de la anestesia en bloques digitales para laceraciones aisladas de los dedos: un ensayo controlado aleatorio. Turk J Emerg Med [Internet]. 2022 [citado 20/03/2023]; 22(3):[aprox. 2p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9355069/

https://doi.org/10.4103/tjem.tjem_344_21

8. Instituto Nacional del Cáncer. Diccionario del NCI. Escala visual analógica [Internet]. Chicago: Instituto Nacional del Cáncer; 2022 [citado 12/04/2023]. Disponible en: https://www.cancer.gov/espanol/publicaciones/diccionarios/diccionario-cancer/def/escala-visual-analogica

9. Ministerio de Salud Pública. Dirección de Registros Médicos y Estadísticas de Salud. Anuario Estadístico de Salud 2022. La Habana: Minsap; 2023 [citado 03/03/2023]. Disponible en: https://files.sld.cu/dne/files/2022/10/Anuario-Estadistico-de-Salud-2021.-Ed-2022.pdf

10. Barrios-López VE, Castelán-Martínez OD, Arteaga-Rubio RL, Hidalgo-Martínez MF, Silva-Jivaja KM, Castañeda-Hernández G, et al. Errores de medicación en un centro de quimioterapia antineoplásica para pacientes hospitalizados en niños. Bol Med Hosp Infant Mex [Internet]. 2022 [citado 20/03/2023]; 79(3):[aprox. 3p.]. Disponible en: https://www.bmhim.com/frame_esp.php?id=309

11. Gomes N, Sibaud V, Azevedo F, Magina S. Toxicidad cutánea de los inhibidores de puntos de control inmunitarios: una revisión narrativa. Acta Med Port [Internet]. 2020 [citado 10/03/2023]; 33(5):[aprox. 3p.]. Disponible en: https://actamedicaportuguesa.com/revista/index.php/amp/article/view/12424/0

https://doi.org/10.20344/amp.12424

12. Merad Y, Derrar H, Tabouri S, Berexi-Reguig F. Candida guilliermondii Onicomicosis que afecta las uñas en un paciente con cáncer de mama bajo quimioterapia con docetaxel. Case Rep Oncol [Internet]. 2021 [citado 10/03/2023]; 14(3): [aprox. 2p.]. Diponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8613606/

https://doi.org/10.1159/000519695

13. Saraswat N, Sood A, Verma R, Kumar D, Kumar S. Cambios en las uñas inducidos por agentes quimioterapéuticos. Indio J Dermatol [Internet]. 2020 [citado 10/03/2023]; 65(3):[aprox. 2p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7292457/

https://doi.org/10.4103/ijd.IJD_37_19

14. Alamri A, Alghamdi Y, Alghamdi A, Albogami DB, Shahada O, AlHarbi A. Paroniquia inducida por ibrutinib y granuloma piógeno periungueal. Cureus [Internet]. 2022 [citado 11/03/2023]; 14(12):e32943. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9874258/

https://doi.org/10.7759/cureus.32943

15. Burzi L, Alessandrini AM, Quaglino P, Piraccini BM, Dika E, Ribero S. Eventos cutáneos asociados con la inmunoterapia del melanoma: una revisión. J Clin Med [Internet]. 2021 [citado 17/02/2023]; 10(14):[aprox. 3p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8308045/

https://doi.org/10.3390/jcm10143047

16. Yorulmaz A, Yalcin B. Paroniquia inducida por panitumumab: un informe de caso y una breve revisión de la literatura. Skin Appendage Disord [Internet]. 2021 [citado 17/02/2023]; 7(2):[aprox. 2p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7991612/

https://doi.org/10.1159/000512036

17. Moellhoff N, Polzer H, Baumbach SF, Kanz KG, Böcker W, Bogner-Flatz V. Unguis incarnatus – terapia conservadora o quirúrgica? Un algoritmo de tratamiento práctico. Cirujano traumatólogo [Internet]. 2021 [citado 19/02/2023]; 124(4): [aprox. 2p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7985053/

https://doi.org/10.1007/s00113-020-00903-6

18. Acosta A, Rolón M, Muñoz C. Técnicas para toma de biopsias ungulares Rev Asoc Colomb Dermatol [Internet]. 2015 [citado 18/03/2023]; 23(1): [aprox. 3p.]. Disponible en: https://www.revista.asocolderma.org.co/index.php/asocolderma/article/view/1066?articlesBySameAuthorPage=2?time=1718204139

19. Maris S, Brands M, Lenskens D, Braeken G, Kemnitz S, Vanhove H, et al. Transcutaneous electrical nerve inhibition using medium frequency alternating current. Sci Rep [Internet]. 2022 [citado 18/03/2023]; 12(1): [aprox. 3p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9437086/

https://doi.org/10.1038/s41598-022-18974-3

Downloads

Published

2025-07-03

How to Cite

1.
Silveira Cuellar ZR, Fuentes Díaz Z, Rodríguez Salazar OB, Puerto Pérez T. Evaluation of transthecal block and traditional digital block in cancer patients with nail toxicity. Acta Méd Centro [Internet]. 2025 Jul. 3 [cited 2025 Jul. 6];19(1):e2309. Available from: https://revactamedicacentro.sld.cu/index.php/amc/article/view/2309

Issue

Vol. 19 (2025): PUBLICACIÓN CONTINUA

Section

Original Articles

License

Copyright (c) 2025 Zunamys Raquel Silveira Cuellar, Zaily Fuentes Díaz, Orlando Bismark Rodríguez Salazar, Tania Puerto Pérez

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Authors who have publications with this journal agree to the following terms:

  1. Authors will retain their copyright and assign to the journal the right of first publication of their work, which will simultaneously be subject to a Creative Commons License / Attribution-Noncommercial 4.0 International (CC BY-NC 4.0) that allows third parties to share the work as long as its author and first publication in this journal are indicated.
  2. Authors may adopt other non-exclusive license agreements for distribution of the published version of the work (e.g., depositing it in an institutional repository or publishing it in a monographic volume) as long as the initial publication in this journal is indicated.
  3. Authors are allowed and encouraged to disseminate their work through the Internet (e.g., in institutional telematic archives or on their web page) before and during the submission process, which can produce interesting exchanges and increase citations of the published work. (See The effect of open access).