关键词: 改良腱鞘麻醉, 传统指根神经阻滞麻醉, 儿童, 手外伤

Abstract: Objective: To probe the advantages and clinical application value of modified transthecal digital block in the treatment of hand trauma in the children,and to provide the references for the selection of anesthesia methods for surgery. Methods: A total of 102 patients (104 digits) required acute or chronic hand surgery were selected.The patients were divided into two groups by the method of random number table,54 patients(54 fingers) were treated with traditional digital block(traditional digital block group),and 48 patients (50 fingers) were anesthetized with modified transthecal digital block(modified transthecal digital block group).The pain detection was performed on the 4 sites within 5 min after anesthesia by using the method of Face,Legs,Activity,Cry,Consolability Behavioral Tool(FLACC)(<7 years old) or Visual Analogue Scale(VAS)(7-18 years old).The 0 score of pain meant that the anesthesia was successful in 5 min after injection.After 5 min,if the child still felt painful and unable to undergo surgery,it was marked as failure,and the method of traditional digital block was used to complete the operation.The successful rate,the onset time,the duration time,and the dose of anesthetic drugs of the patients in two groups were detected. Results: The successful rate of the patients in modified transthecal digital block group had no significantly difference compared with traditional digital block group (P>0.05).Compared with traditional digital block group,the average onset time of anesthetic drug of the patients in modified transthecal digital block group was shortened (P<0.05),and the average dose of anesthetic drug was decreased (P<0.05). Conclusion: The modified transthecal digital block has the advantages of smaller dose,quicker effect,easier operation,and less pain.It is suitable for the clinical application in the treatment of hand trauma in the pediatric patients.

Key words: children, traditional digital block, modified transthecal digital block, hand trauma