完全清醒技术在肘管综合征术中的应用

Clinical application of wide-awake technique in surgical treatment of cubital tunnel syndrome

目的:探讨完全清醒无止血带局部止血麻醉技术在肘管综合征手术中的临床疗效。方法:选择2020年3月~2023年3月弋矶山医院采用完全清醒技术治疗肘管综合征患者21例,均为单侧,评估麻醉、术中和术后的疼痛和焦虑情况及术中出血情况,术后观察麻醉不良反应和术区皮肤愈合情况,采用顾玉东肘管综合征评定标准对功能恢复进行评价。结果:21例患者均获得随访,随访时间151.0~425.0(264.00±71.88)d。术中患者无疼痛及焦虑,疼痛数字评分法(NRS)评分0分,术野清晰,无血肿及皮缘坏死等并发症。末次随访临床疗效优9例,良10例,可1例,差1例,总体优良率90.5%。结论:完全清醒技术治疗肘管综合征安全有效,方法可行。

Objective:To evaluate the clinical efficacy of wide-awake local anesthesia with no use of tourniquet in the surgical treatment of cubital tunnel syndrome.Methods:Twenty-one unilateral cubital tunnel syndrome patients,treated with wide-awake technique,were included from March 2020 and March 2023.The following indicators were evaluated and observed,including the anesthetic,intraoperative and postoperative pain and anxiety,intraoperative bleeding,and the adverse effects of anesthesia and skin healing in the operative area after surgery.The functional recovery was evaluated according to the assessment criteria for cubital tunnel syndrome developed by Gu Yudong.Results:All patients were followed up for 151 to 425 days[mean:(264.00±71.88)d].Patients had no pain or anxiety during the operation(NRS score of 0).The surgical field was clear,and no complications such as hematoma or skin necrosis were observed.Evaluation of the clinical efficacy at the final follow-up indicated excellent in 9 cases,good in 10 cases,fair in 1 case,and poor in 1 case.The overall excellent and good rate was 90.5%.Conclusion:Wide-awake technique is safe,effective and feasible for the surgical treatment of cubital tunnel syndrome.