拇趾甲沟炎拔甲术中局部麻醉方法的改进

Study of Anesthetic Effect with Two Local Anesthesia Methods in Nail Extraction of Paronychia

目的观察两种局部麻醉方法在拇趾甲沟炎拔甲术中的应用效果。方法将2010年6月至2011年10月在解放军总医院门诊外科行单侧部分拔甲术的72例拇趾甲沟炎患者随机分为研究组和对照组各36例,研究组采用甲根上局部浸润麻醉后实施拔甲术,对照组采用趾根神经阻滞麻醉后实施拔甲术;比较两组患者的麻醉效果、麻醉剂用量、麻醉时间及拔甲术全程操作时间。结果两种局部麻醉方法的的注药时间及手术过程中的疼痛评分差异无统计学意义(P>0.05);研究组麻醉剂用量少于对照组,麻醉时间及拔甲术全程操作时间短于对照组,差异均有统计学意义(均P<0.01)。结论拇趾甲沟炎拔甲患者采用甲根上局部浸润麻醉可达到满意的麻醉效果,且麻醉剂用量少、麻醉及手术时间短,是一种更加安全有效的局部麻醉方法。

Objective To observe the application effect of the two local anesthesia methods in nail extraction of paronychia. Methods Seventy two patients with nail extraction of paronychia were randomly divided into two groups. Patients in the study group were given local infiltration anesthesia. Patients in the control group were given toe nerve block anesthesia. Anesthetic effect, anesthetic dosage, duration of anesthesia, and the whole operation time of nail extraction of the two groups were compared. Results The duration of anesthesia and injection pain score during the nail extraction between the two local anesthetic methods have no significant difference（P〉0.05）. The anesthetic dosage in the study group was significantly less than that in the control group（P〈0.01）. The duration of anesthesia and the whole operation time of nail extrac- tion in the study group were significantly shorter than that in the control group（P〈0.01）. Conclusion The local infiltration anesthesia method for nail extraction of paronychia can achieve satisfactory anesthetic effect, decrease the anesthetic dosage, shorten the duration of anesthesia and the whole operation time of nail extraction. It is a simple and safe method for further clinical application.