腕管麻醉在手外科的应用

The Method of Carpal Tunnel Anesthesia Used in Hand Surgery

目的:介绍腕管麻醉在手外科中的应用。方法:33例手外伤病人在腕管麻醉下接受了手术。手术时,首先置腕关节于中立位,在腕管内注入1%的利多卡因10 ml进行阻滞麻醉。进针点位于腕掌面远侧腕横纹上,掌长肌腱与桡侧腕屈肌肌腱之间,垂直进针,有异感后徐徐注药。麻醉后进行手外伤常规冲洗,消毒,铺巾,手术。结果:所有33例病人均未应用臂丛麻醉,为加强麻醉效果,个别病人加用指根阻滞麻醉。术中麻醉满意,术后随访无正中神经损伤表现。结论:腕管麻醉为腕管内正中神经的阻滞麻醉,该方法可以保证正中神经分布区域的手术,而该区恰为手外伤的高发区。麻醉于腕管内进行,不会损伤其他血管,神经。腕管接近伤区,定位局限,准确,副作用轻。麻醉由手术者完成,可简化操作。该方法为一种简便、安全、准确、有效、经济的麻醉方法。

Objective The aim of this work was to introduce the method of carpal tunnelabesthesia that was usedin hand surgery. Methods 33 patients of hands injury have been used this method of carpal tunnel abesthesia besides anesthesia brachial during the operation by the operating surgeons. When operation, first take the wrist joint in neutrality position,then inject 1% Lidocain 10 ml in carpal tunnel. The inject point lie in wrist palmar distal crease, between the palmaris longus tendon and the flexor carpi radialis tendon. The point of the needle inter skin in 90°. After induce 2 minutes, according to routine to wash, sterilize and performoperation, Results The anesthesia was satisfactory. After operation, there are not the injury manifestation in the medium nerves and the region. Conclusion This method is to impede abesthesia the medium nerve,it permit the operation in the region where are controlled by the nerve. The anesthesia point is near the injury,the action is miore sharp. There is not the vessel in the tunnel. The anesthesiais performed only by the surgeon. So this is a simple,safe,sharp,effective,economic anesthesia method in hand surgery.