Öztürk Tülün, Çevikkalp Eralp, Nizamoglu Funda, Özbakkaloğlu Alper, Topcu İsmet
Department of Anaesthesiology and Reanimation, Celal Bayar University School of Medicine, Manisa, Turkey.
Department of Cardiovascular Surgery, Celal Bayar University School of Medicine, Manisa, Turkey.
Turk J Anaesthesiol Reanim. 2016 Apr;44(2):91-5. doi: 10.5152/TJAR.2015.66933. Epub 2016 Apr 1.
This study aimed to investigate the efficacy of femoral block and unilateral spinal anaesthesia on analgesia, haemodynamics and mobilization during endovenous ablation in patients with lower extremity venous insufficiency.
Forty patients of ASA physical status I and II, with ages ranging between 30 and 45 years, and who were scheduled for endovenous laser ablation for varicose veins were prospectively enrolled in this study. Patients were randomized into a unilateral spinal anaesthesia group (group HS, n=20) or a femoral block group (group F, n=20). Group HS received 7.5-10 mg of heavy bupivacaine for unilateral spinal anaesthesia, while group F received 100 mg prilocaine for femoral block with ultrasound guidance. The level of motor blockage (Bromage score), visual pain score, mean heart rate and mean arterial pressures were recorded at postoperative 0, 1, 2, 3d and 6 h, respectively.
Perioperative visual pain score values in both groups were <4. None of the groups required an additional analgesic agent. Bromage scores were significantly lower in group F than in group HS during the postoperative period (p<0.01). Motor function returned to normal in all patients at 3 h in group F and at 6 h in group HS. Postoperative mean heart rate and arterial pressure did not differ between the groups (p>0.05).
In patients with lower extremity venous insufficiency who were undergoing endovenous laser ablation, an ultrasound-guided femoral block provided similar analgesia with that of unilateral spinal anaesthesia. In group F, the duration of anaesthesia and mobilization time was shorter.
本研究旨在探讨股神经阻滞和单侧脊髓麻醉对下肢静脉功能不全患者在静脉腔内消融术中镇痛、血流动力学及活动能力的影响。
前瞻性纳入40例年龄在30至45岁之间、ASA身体状况为I级和II级、计划行静脉曲张静脉腔内激光消融术的患者。患者被随机分为单侧脊髓麻醉组（HS组，n = 20）或股神经阻滞组（F组，n = 20）。HS组接受7.5 - 10 mg重比重布比卡因进行单侧脊髓麻醉，而F组在超声引导下接受100 mg丙胺卡因进行股神经阻滞。分别在术后0、1、2、3天及6小时记录运动阻滞水平（Bromage评分）、视觉疼痛评分、平均心率和平均动脉压。
两组围手术期视觉疼痛评分均<4。两组均无需额外使用镇痛剂。术后F组的Bromage评分显著低于HS组（p<0.01）。F组所有患者在3小时时运动功能恢复正常，HS组在6小时时恢复正常。两组术后平均心率和动脉压无差异（p>0.05）。
在接受静脉腔内激光消融术的下肢静脉功能不全患者中——超声引导下的股神经阻滞与单侧脊髓麻醉提供的镇痛效果相似。在F组中，麻醉持续时间和活动时间较短。
