摘要
目的探讨应用指屈肌腱鞘浸润麻醉进行急诊手指外伤手术的临床应用效果。方法 2009年11月～2010年10月,187例253指手指外伤采用指屈肌腱鞘浸润麻醉进行手术,其中拇指32指,食指84指,中指92指,环指38指,小指7指。结果麻醉起效时间平均1.5 min;麻醉效果持续时间平均2 h;麻醉药物用量单指平均2 ml。麻醉范围:拇指掌指关节以远部分,第2～5指掌指关节以远部分及相邻各半指。麻醉效果以手指中末节最佳,手指近节指背侧较差,拇指近节指背侧几乎无麻醉作用。结论指屈肌腱鞘浸润麻醉具有操作简单、起效迅速、用药安全、副作用小、效果满意等优点,特别适用于手指外伤患者的掌指关节以远掌侧及中末节指背侧的麻醉。对于损伤累及拇指背侧或手指近节指背侧的患者则最好采用传统的指背神经阻滞术。
Objective To investigate the effect of transthecal digital block in digital injury. Methods During the period from November 2009 to October 2010, The technique of transthecal digital block was used in 253 fingers of 187 digital injury patients, including 32 thumbs, 84 forefingers, 92middle fingers, 38 ring fingers and 7 little fingers. Results The average time to get effect was 1.5 minutes and the average duration was 2 hours. The average dosage of anesthetic was 2 ml every finger. The bounds of anesthesia：The effective area was distal to metacarpophalangeal joint and half of neighbouring finger. The effect of the distal and middle phalanx was best and the dorsal aspect of proximal phalanx was poor. There is almost no effect on the dorsal aspect of proximal phalanx of thumb. Conclusion The technique of transthecal digital block is a simply - operated anesthetic method. Taking effect is very rapid. It is safe, especially suitable for the digital anesthesia of palmar aspect distal to metacarpophalangeal joint and dorsal aspect of the distal and middle phalanxes. But the patients who had the injury at the dorsum of the thumb or the proximal phalanx fingers are better to use traditional digital block.
出处
《中国医学创新》
CAS
2010年第35期100-101,共2页
Medical Innovation of China
