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股神经阻滞在静脉腔内射频消融联合点状剥脱治疗大隐静脉曲张中的应用。

Application of Femoral Nerve Block in Treating Great Saphenous Vein Insufficiency by Endovenous Radiofrequency Ablation Combined with Punctate Stripping.

机构信息

Department of Vascular and Interventional Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.

出版信息

Clin Appl Thromb Hemost. 2023 Jan-Dec;29:10760296231220054. doi: 10.1177/10760296231220054.

Abstract

PURPOSE

To evaluate the efficacy and safety of ultrasound-guided femoral nerve block (FNB) in treating great saphenous vein (GSV) insufficiency by endovenous radiofrequency ablation (EVRA) combined with punctate stripping (PS).

METHODS

This was a single-center, retrospective cohort study. A total of 135 patients were divided into Group A (59 patients) and Group B (76 patients). All patients received tumescent anesthesia during the operation, and group A received an additional ultrasound-guided FNB before the procedure. Intraoperative and postoperative pain score, the volume of tumescent anesthesia solution (TAS), and other indicators were compared in two groups.

RESULTS

Group A had a significantly lower intraoperative pain visual analog scale than group B (2.7 ± 1.2 vs 5.2 ± 1.5,  < 0.001). The volume of TAS in group A was significantly lower than that in group B (198 ± 26.6 ml vs 338 ± 34.7 ml,  < 0.001). Postoperative muscle strength of group A was significantly decreased compared with group B (54.2% vs 3.90%,  < 0.001); no patient had severe limitation of active movements in both groups, and all motor blocks recovered within 24 h. The incidence of skin ecchymosis in group A was lower than that in group B (18.6% vs 46.1%,  = 0.001). The operation duration of the two groups had no statistically significant difference.

CONCLUSIONS

Ultrasound-guided FNB in treating GSV insufficiency by EVRA combined with PS significantly relieved intraoperative pain and reduced the dosage of TAS and the incidence of skin ecchymosis without increasing the complications of anesthesia or any other surgical complications.

摘要

目的

评估超声引导股神经阻滞(FNB)在经静脉射频消融(EVRA)联合点状剥脱术(PS)治疗大隐静脉曲张(GSV)中的疗效和安全性。

方法

这是一项单中心回顾性队列研究。共纳入 135 例患者,分为 A 组(59 例)和 B 组(76 例)。所有患者在手术中均接受肿胀麻醉,A 组在术前加行超声引导 FNB。比较两组患者术中及术后疼痛评分、肿胀麻醉液(TAS)用量等指标。

结果

A 组患者术中视觉模拟评分法(VAS)疼痛评分明显低于 B 组(2.7±1.2 比 5.2±1.5,  < 0.001)。A 组 TAS 用量明显低于 B 组(198±26.6 ml 比 338±34.7 ml,  < 0.001)。A 组术后肌力较 B 组明显下降(54.2%比 3.90%,  < 0.001);两组均无患者出现严重主动活动受限,所有运动阻滞均在 24 h 内恢复。A 组皮肤瘀斑发生率明显低于 B 组(18.6%比 46.1%,  = 0.001)。两组手术时间无统计学差异。

结论

超声引导 FNB 治疗 EVRA 联合 PS 治疗 GSV 可明显减轻术中疼痛,减少 TAS 用量和皮肤瘀斑发生率,且不增加麻醉或其他手术并发症。

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