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通过利多卡因和罗哌卡因联合肿胀麻醉提高静脉曲张治疗中的患者舒适度。

Enhancing patient comfort in varicose vein treatment through combined lidocaine and ropivacaine tumescent anesthesia.

作者信息

Li Yubo, Li Tan

机构信息

Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Department of Vascular Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.

出版信息

Front Surg. 2024 May 9;11:1359474. doi: 10.3389/fsurg.2024.1359474. eCollection 2024.

Abstract

OBJECTIVE

To compare the analgesic effects of specific tumescent anesthetic solutions composed of lidocaine, ropivacaine, or a combination of lidocaine and ropivacaine during endovenous radiofrequency ablation for the treatment of great saphenous vein varicosities.

METHOD

This study included 149 patients with lower limb varicose veins who were admitted to our department between 2019 and 2023. The patients were randomly assigned to three groups: the lidocaine group (Group I), the ropivacaine group (Group II), and the lidocaine + ropivacaine group (Group III). Intraoperative vital signs, intraoperative and postoperative visual analog scale (VAS) pain scores, and long-term treatment outcomes were assessed using the venous clinical severity score (VCSS) based on clinical performance.

RESULTS

There were no significant differences in age, body mass index, operative time, or blood loss among the three groups ( ≥ 0.05). The differences in the mean arterial pressure and heart rate during surgery in Group II were significantly greater than those in Groups I and III ( < 0.05). The intraoperative VAS scores in Group II were higher than those in Groups I and III ( < 0.05) and at 8 and 12 h postoperatively. There were no significant differences in VCSS among the groups ( ≥ 0.05).

CONCLUSION

The use of a tumescent anesthetic solution composed of lidocaine and ropivacaine significantly improved patient comfort during the perioperative period without affecting surgical outcomes. This formulation can be considered safe and reliable for preparing tumescent anesthesia solutions.

摘要

目的

比较利多卡因、罗哌卡因或两者联合组成的特定肿胀麻醉溶液在大隐静脉静脉曲张腔内射频消融治疗中的镇痛效果。

方法

本研究纳入了2019年至2023年间收治于我科的149例下肢静脉曲张患者。患者被随机分为三组:利多卡因组(I组)、罗哌卡因组(II组)和利多卡因+罗哌卡因组(III组)。根据临床表现,使用静脉临床严重程度评分(VCSS)评估术中生命体征、术中和术后视觉模拟评分(VAS)疼痛评分以及长期治疗效果。

结果

三组患者在年龄、体重指数、手术时间或失血量方面无显著差异(≥0.05)。II组手术期间平均动脉压和心率的差异显著大于I组和III组(<0.05)。II组术中VAS评分高于I组和III组(<0.05),且术后8小时和12小时也更高。各组间VCSS无显著差异(≥0.05)。

结论

使用由利多卡因和罗哌卡因组成的肿胀麻醉溶液可显著提高围手术期患者的舒适度,且不影响手术效果。该配方可被认为是制备肿胀麻醉溶液安全可靠的选择。

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