Department of Radiology, Akdeniz University School of Medicine, 07050, Arapsuyu, Antalya, Turkey.
Cardiovasc Intervent Radiol. 2013 Feb;36(1):150-7. doi: 10.1007/s00270-012-0366-4. Epub 2012 Mar 14.
Endovenous laser ablation may be associated with significant pain when performed under standard local tumescent anesthesia. The purpose of this study was to investigate the efficacy of femoral and sciatic nerve blocks for analgesia during endovenous ablation in patients with lower extremity venous insufficiency.
During a 28-month period, ultrasound-guided femoral or sciatic nerve blocks were performed to provide analgesia during endovenous laser ablation in 506 legs and 307 patients. The femoral block (n = 402) was performed at the level of the inguinal ligament, and the sciatic block at the posterior midthigh (n = 124), by injecting a diluted lidocaine solution under ultrasound guidance. After the blocks, endovenous laser ablations and other treatments (phlebectomy or foam sclerotherapy) were performed in the standard fashion. After the procedures, a visual analogue pain scale (1-10) was used for pain assessment.
After the blocks, pain scores were 0 or 1 (no pain) in 240 legs, 2 or 3 (uncomfortable) in 225 legs, and 4 or 5 (annoying) in 41 legs. Patients never experienced any pain higher than score 5. The statistical analysis revealed no significant difference between the pain scores of the right leg versus the left leg (p = 0.321) and between the pain scores after the femoral versus sciatic block (p = 0.7).
Ultrasound-guided femoral and sciatic nerve blocks may provide considerable reduction of pain during endovenous laser and other treatments, such as ambulatory phlebectomy and foam sclerotherapy. They may make these procedures more comfortable for the patient and easier for the operator.
在标准局部肿胀麻醉下进行静脉内激光消融术时，可能会引起明显疼痛。本研究的目的是探讨股神经和坐骨神经阻滞在下肢静脉功能不全患者静脉内消融治疗中的镇痛效果。
在 28 个月期间，对 307 名患者的 506 条腿进行了超声引导下股神经或坐骨神经阻滞，以在静脉内激光消融期间提供镇痛。股神经阻滞（n=402）在腹股沟韧带水平进行，坐骨神经阻滞（n=124）在后大腿中进行，在超声引导下注入稀释的利多卡因溶液。阻滞完成后，按标准方式进行静脉内激光消融和其他治疗（静脉切除术或泡沫硬化疗法）。治疗后，采用视觉模拟疼痛评分（1-10）评估疼痛。
阻滞完成后，240 条腿的疼痛评分为 0 或 1（无疼痛），225 条腿的疼痛评分为 2 或 3（不适），41 条腿的疼痛评分为 4 或 5（恼人）。患者从未经历过任何疼痛评分高于 5 分的情况。统计学分析显示，右腿与左腿的疼痛评分（p=0.321）和股神经阻滞与坐骨神经阻滞后的疼痛评分（p=0.7）之间无显著差异。
超声引导下股神经和坐骨神经阻滞可显著减轻静脉内激光和其他治疗（如门诊静脉切除术和泡沫硬化疗法）引起的疼痛。它们可以使这些操作对患者更舒适，对操作者更容易。
