WALANT技术在手部狭窄性腱鞘炎手术中的应用  

Clinical application of wide-awake local anesthesia no tourniquet(WALANT)in trigger finger release surgery

作　　者：王爽 戚仁竞 袁超群 顾加祥 WANG Shuang;QI Renjing;YUAN Chaoqun(Yangzhou University,Yangzhou,Jiangsu,225009,China)

机构地区：[1]扬州大学,江苏扬州225009 [2]扬州大学临床医学院手足外科,江苏扬州225001

出　　处：《实用手外科杂志》2022年第4期464-466,共3页Journal of Practical Hand Surgery

摘　　要：目的介绍完全清醒无止血带局部麻醉(wide awake local anesthesia no tourniquet,WALANT)技术在手部狭窄性腱鞘炎手术中的应用,并探讨其治疗效果。方法2018年6月-2020年6月,对20例手部狭窄性腱鞘炎患者采用WALANT技术行腱鞘切开手术,采用视觉模拟评分法(VAS)对术前、术中及术后术区疼痛进行评估,术中评估出血量及手指主动活动情况,术后观察术区皮肤血供及麻醉不良反应。结果术中止血效果满意,不影响运动功能。局部麻醉操作时会有不同程度的疼痛感(VAS评分2~3分),术中无疼痛(VAS评分0分),术后有不同程度的疼痛(VAS评分1~2分)。术后术区皮肤均一期愈合,无麻醉不良反应。20例均获得随访,时间3~6个月,平均4.5个月,未见腱鞘炎复发。结论WALANT技术应用于手部狭窄性腱鞘炎手术安全有效,在起到良好的止血效果同时,患者完全清醒,无疼痛,无需止血带,患者可以随时主动活动手指,操作简单,有利于手外科日间手术的开展。Objective To explore the application and clinical effect of wide awake local anesthesia no tourniquet in the surgery of trigger finger.Methods From June 2018 to June 2020,20 patients with trigger finger were treated by wide awake technique.The anesthetic,intraoperative and postoperative pain were evaluated with the use of visual analog scale(VAS),operative field bleeding and active movement of finger in operation were assessed,postoperative blood supply of skin in surgical area and anesthetic complications were observed.Results The hemostasis effect was satisfactory and the motor function was not affected during operation.Slight pain occurred during injection on the first poke(VAS score ranged from 2 to 3);no pain during operation(VAS score was 0);mild or moderate pain(VAS score ranged from 1 to 2)after operation occurred.Surgical skin healed well at the stageⅠwithout side effect of anesthesis.Twenty patients were followed up from 3 to 6 months with an average of 4.5 months,and no recurrences were found.Conclusion Wide awake local anesthesia no tourniquet is safe and effective in treating trigger finger.This new technique without tourniquet receives a good hemostatic effect,and enables patients to be fully awake,painless.Patients can actively move their fingers at any time.The simple operation is conducive to the development of day surgery in hand surgery.

关 键 词：WALANT技术 腱鞘炎 日间手术 手外科 疼痛评分 

分 类 号：R687.2[医药卫生—骨科学]