肿胀麻醉液温度对腔内激光消融治疗下肢静脉曲张术中及术后疼痛的影响  

Effect of temperature for tumescence anesthesia solution on intraoperative and postoperative pain of endovenous laser ablation of lower extremity varicose vein

作　　者：罗丽华[1] 陈柱[2] 肖恩华[2] 马聪[2] LUO Lihua;CHEN Zhu;XIAO Enhua;MA Cong(Operating Room;Department of Radiology, Second Xiangya Hospital, Central South University, Changsha 410011, China)

机构地区：[1]中南大学湘雅二医院手术室,长沙410011 [2]中南大学湘雅二医院放射科,长沙410011

出　　处：《中南大学学报（医学版）》2018年第6期651-655,共5页Journal of Central South University ：Medical Science

基　　金：国家自然科学基金(81601471)~~

摘　　要：目的:比较冷和常温肿胀麻醉液(以下简称肿麻液)对静脉腔内激光消融术治疗下肢静脉曲张术中及术后疼痛的影响。方法:51名下肢静脉曲张的患者均采用静脉腔内激光消融治疗,术中均采用肿麻液进行静脉周围的局部麻醉。根据肿麻液的温度将患者分为A组(n=26)[采用常温肿麻液(24℃)]和B组(n=25)[采用冷肿麻液(4℃)],并采用数字评定量表(number rating scale,NRS)在手术当天及术后1,2,3 d进行疼痛评估。结果:两组的术中平均线性静脉腔内能量强度(linear endovenous energy density,LEED)差异无统计学意义(P>0.05)。术中A组和B组没有感受到明显疼痛的患者比例分别为30.8%和64.0%,A组患者术中无疼痛的比例低于B组(P<0.05)。A组患者手术当天、术后第1,2,3天平均NRS评分分别为4.3,3.5,3.0和1.6,B组为2.1,1.0,0.8和0.3;A组术后当天及术后1,2,3 d的平均NRS评分高于B组,两组间差异有统计学意义(P<0.05)。术后第1天A组只有30.8%的患者恢复日常活动,B组为68%,A组恢复日常活动的比例小于B组。结论:在静脉腔内激光消融术治疗下肢静脉曲张过程中,使用冷肿麻液能够比常温肿麻液更好地减少术中及术后疼痛。Objective： To compare the eff ect of cold or room temperature of tumescence anesthesia solution on pain perception during and aft er endovenous laser ablation （EVLA） for varicose veins of lower limb.Methods： A total of 51 patients with lower extremity varicose vein were treated by EVLA with tumescence anesthesia solution. All patients were used for local anesthesia and randomly divided into 2 groups according to the temperature of tumescence anesthesia solution： Group A （n=26） with room temperature （24 ℃） of tumescence anesthesia solution and Group B （n=25） with cold （4 ℃） tumescence anesthesia solution. Number rating scale （NRS） was recorded immediately after the procedure and postoperative 1, 2, 3 day. Patients were asked to register pain scores during the week.Results： The mean linear endovenous energy density （LEED） in the 2 groups was not significantly different （P〉0.05）. The ratio of patients without pain during the operation in the Group A was lower than that in the Group B （30.8% vs 64%, P〈0.05）. On the day of operation and postoperative day 1, 2, 3, the average number rating scale （NRS） scores in the Group A were greater than those in the Group B （P〈0.05）. Postoperative day 1, only 30.8% of the patients in the Group A resumed daily activities, which was lower than that （68% of the patients） in the Group B.Conclusion： In the process of EVLA for varicose veins of lower limb, there is less pain during operation and post-operation using cold tumescence anesthesia solution comparing room temperature tumescence anesthesia solution.

关 键 词：肿胀麻醉液 静脉腔内激光消融 下肢静脉曲张 温度 疼痛 

分 类 号：R654.4[医药卫生—外科学]