Creton D
Clinique Ambroise Paré, Nancy.
Phlebologie. 1991 Apr-Jun;44(2):303-11; discussion 311-2.
700 operations involving complete removal of varicose veins in a single stage by invaginated long stripping and phlebectomies under local anesthesia on an out-patient basis were reviewed. Anesthesia consisted of local injections and a femoral block using Mepivacaine or Lidocaine. The out-patient approach adopted did not cause any complications. 95% of patients were satisfied with the method of anesthesia. Three types of neurological sequelae were studied: local numbness due to tearing of a strip of nerve by Muller's hook (7%) was transitory: sub-malleolar numbness was avoided when the lower incision for the stripping was low and sub-malleolar; damage to the saphenous nerve occurs in 1.2 per cent of cases following general anesthesia because of recognition of the particular pain associated with stretching of the nerve during stripping and passage through this junctional area by the Müller technique.
回顾了700例在门诊局部麻醉下通过内翻长剥脱术和静脉切除术一期完全切除静脉曲张的手术。麻醉包括局部注射和使用甲哌卡因或利多卡因的股神经阻滞。所采用的门诊手术方法未引起任何并发症。95%的患者对麻醉方法满意。研究了三种类型的神经后遗症:因米勒钩撕裂一条神经带导致的局部麻木(7%)是暂时的;当剥脱术的下切口较低且位于内踝下时,可避免内踝下麻木;全身麻醉后,由于在剥脱过程中识别出与神经拉伸相关的特殊疼痛,以及通过米勒技术穿过该交界区域,1.2%的病例会发生隐神经损伤。