The Fingernail Cocktail: Improving Preoperative Preparation for Nail Procedures [letter]

The anticipation of pain surrounding any nail procedure often creates a great deal of anxiety for many patients. All too often patients’ fears are quickly confirmed with the initial pain of delivering adequate anesthesia to the finger. Many techniques have been described to ease the pain associated with local anesthesia including distraction, use of a 30-gauge needle or buffered anesthetic, slow injection, pre-injection with cryogen spray, and application of topical local anesthetics. We present a unified approach to the preoperative preparation for nail procedures that minimizes patient discomfort, improves preoperative antisepsis, and softens the nail plate for
easier manipulation.