CAJ | 학술논문

背景：指根麻醉是中小成人手外伤手术中常用的麻醉方法，而近年来，改良屈指腱鞘内麻醉逐渐被推崇，具有起效快、效果好、并发症少等优势。 　　目的：通过前瞻性随机对照研究，分析改良屈指腱鞘内麻醉与指根麻醉在急诊成人手外伤临床麻醉效果。 　　方法：经筛选共60例急诊成人手外伤患者纳入研究，入选患者随机分为改良屈指腱鞘内麻醉组与指根麻醉组，麻醉全由同一名医生完成。记录两组麻醉操作时间、局麻药用量、麻醉起效时间、持续时间、麻醉成功率、目测类比疼痛评分，并观察记录相关并发症。 　　结果与结论：改良屈指腱鞘内麻醉、传统指根麻醉效果均确切。两组麻醉起效时间、持续时间、麻醉成功率及并发症差异均无显著性意义(P>0.05)，但在操作时间、局麻药用量、患者目测类比评分方面改良屈指腱鞘内麻醉组优于指根麻醉组(P<0.05)。结果表明改良屈指腱鞘内麻醉较传统指根麻醉更方便，患者痛苦较少，是一种安全可靠的麻醉方式。
배경：지근마취시중소성인수외상수술중상용적마취방법，이근년래，개량굴지건초내마취축점피추숭，구유기효쾌、효과호、병발증소등우세。 　　목적：통과전첨성수궤대조연구，분석개량굴지건초내마취여지근마취재급진성인수외상림상마취효과。 　　방법：경사선공60례급진성인수외상환자납입연구，입선환자수궤분위개량굴지건초내마취조여지근마취조，마취전유동일명의생완성。기록량조마취조작시간、국마약용량、마취기효시간、지속시간、마취성공솔、목측류비동통평분，병관찰기록상관병발증。 　　결과여결론：개량굴지건초내마취、전통지근마취효과균학절。량조마취기효시간、지속시간、마취성공솔급병발증차이균무현저성의의(P>0.05)，단재조작시간、국마약용량、환자목측류비평분방면개량굴지건초내마취조우우지근마취조(P<0.05)。결과표명개량굴지건초내마취교전통지근마취경방편，환자통고교소，시일충안전가고적마취방식。
BACKGROUND:Dorsal digital block refers to the commonly used anesthesia for adults in smal or moderate hand injury surgeries, but in recent years, modified transthecal digital block technique is gradualy respected, which is favored with a rapid and good effect and fewer complications. OBJECTIVE:To evaluate the clinical anesthetic outcomes of modified transthecal digital block and traditional dorsal digital block technique for the treatment of hand injury of adults in emergency by a prospective randomized controled study. METHODS:Totaly 60 adult patients with hand injury were enroled and divided into two groups of modified transthecal digital block and traditional dorsal digital block randomly. Blocks were performed by one single surgeon. The operation time, local anesthetic dose, onset time of anesthesia, duration of anesthesia, success rate of anesthesia, visual analogue scale scores and complications were recorded. RESULTS AND CONCLUSION:The anesthesia effects in the two groups were acceptable. There was no significant difference in the onset time of anesthesia, duration of anesthesia, success rate of anesthesia and complications between the two groups (P > 0.05). The operation time of anesthesia, local anesthetic dose, and visual analogue scale scores were significantly different between the two groups (P< 0.05). Modified transthecal digital block is more convenient and has less pain than the traditional root digital block, which is a safe and reliable anesthetic technique.