The clinical application of ultrasound-guided local anesthesia in radionfrequency endovenous obliteration in treatment of great saphenous vein varices_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LI Liang ¹ ,  TANG Xiaoyong ¹ , LIU Qiangguang ¹ , ZHAO Tiehua ¹ , WANG Jiaming ¹ , NIU Shaoxiong ¹ , WANG Xuejun ¹ , ZHU Xiaoming ² , SHENG Li ³ , LI Qiang ¹

1. Department of General Surgery, Gansu Province Hospital of Traditional Chinese Medicine, Lanzhou 730050, P. R. China;
2. Department of Intraday-Ward, Gansu Province Hospital of Traditional Chinese Medicine, Lanzhou 730050, P. R. China;
3. Department of Medical Ultrasonics, Gansu Province Hospital of Traditional Chinese Medicine, Lanzhou 730050, P. R. China;

Corresponding?author：

TANG Xiaoyong, Email: 1351281436@qq.com

Keywords：

great saphenous vein varices; local anesthesia; ultrasound-guided; radiofrequency endovenous obliteration

DOI：

10.7507/1007-9424.201908037

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Objective This study is designed to explore the indications, clinical pathway, and benefits of ultrasound-guided local anesthesia in radiofrequency endovenous obliteration (RFO) for great saphenous vein varices (GSV).Methods A total of 350 patients diagnosed with GSV were divide into observation group (n=175) and control group (n=175). Patients in the observation group underwent local anesthesia RFO, and patients in the control group underwent intravertebral anesthesia. Comparion in the visual analogue scale pain scores (VAS) when anesthesia and after surgery, operative indexes, recovery time, satisfaction, and complications were performed.Results Compared with the control group, the VAS score with anesthesia time were lower (P<0.05), while in the surgery were higher (P<0.05), as well as the operative time, the first time for underground activity, normal activity time, incidences of complication of anesthesia and urinary were shorter (P<0.05), and the satisfaction rate was higher (P<0.05). There was no difference in the pain score of 12 h and 24 h after surgery, blood loss, volume of anesthetic swelling fluid, postoperative hospitalization, incidences of urinary tract infection, incisional infection, and deep vein thrombosis (P>0.05).Conclusions The RFO is feasible and safe after local anaesthesia. It can decrease the complication of anesthesia, that will promote the patient soon to be restored to health.

Citation： LI Liang, TANG Xiaoyong, LIU Qiangguang, ZHAO Tiehua, WANG Jiaming, NIU Shaoxiong, WANG Xuejun, ZHU Xiaoming, SHENG Li, LI Qiang. The clinical application of ultrasound-guided local anesthesia in radionfrequency endovenous obliteration in treatment of great saphenous vein varices. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2020, 27(4): 423-428. doi: 10.7507/1007-9424.201908037 Copy

1.	中華醫學會外科分會血管外科學組. 慢性下肢靜脈疾病診斷與治療中國專家共識. 中華普通外科雜志, 2014, 29(4): 246-252.
2.	宋均飛, 殷世武. 大隱靜脈曲張微創治療進展. 安徽醫藥, 2019, 23(3): 437-440.
3.	Ogawa T, Hoshino S, Midorikawa H, et al. Clinical results of radiofrequency endovenous obliteration for varicose veins. Surg Today, 2005, 35(1): 47-51.
4.	Winterborn R. Randomized clinical trial of VNUS ClosureFAST radiofrequency ablation versus laser for varicose veins (Br J Surg 2010; 97: 810- 818). Br J Surg, 2010, 97(6): 818-819.
5.	孫麗娜, 覃文, 錢立友, 等. 大隱靜脈射頻消融閉合術治療大隱靜脈曲張的臨床分析. 醫學理論與實踐, 2019, 32(13): 2052-2054.
6.	Marsh P, Price BA, Holdstock J, et al. Deep vein thrombosis (DVT) after venous thermoablation techniques: rates of endovenous heat-induced thrombosis (EHIT) and classical DVT after radiofrequency and endovenous laser ablation in a single centre. Eur J Vasc Endovasc Surg, 2010, 40(4): 521-527.
7.	李亮, 朱曉銘, 唐曉勇, 等. 360 例下肢靜脈性潰瘍個體化治療的臨床分析. 中國普外基礎與臨床雜志, 2016, 23(5): 590-593.
8.	Nicolini P, Closure Group. Treatment of primary varicose veins by endovenous obliteration with the VNUS closure system: results of a prospective multicentre study. Eur J Vasc Endovasc Surg, 2005, 29(4): 433-439.
9.	Puggioni A, Marks N, Hingorani A, et al. The safety of radiofrequency ablation of the great saphenous vein in patients with previous venous thrombosis. J Vasc Surg, 2009, 49(5): 1248-1255.
10.	Schmedt CG, Meissner OA, Hunger K, et al. Evaluation of endovenous radiofrequency ablation and laser therapy with endoluminal optical coherence tomography in an ex vivo model. J Vasc Surg, 2007, 45(5): 1047-1058.
11.	Kundu S, Achar S. Principles of office anesthesia: part Ⅱ. Topical anesthesia. Am Fam Physician, 2002, 66(1): 99-102.
12.	吳孟超, 吳在德. 黃家駟外科學. 第 7 版. 北京: 人民衛生出版社, 2008: 295.
13.	Achar S, Kundu S. Principles of office anesthesia: part Ⅰ. Infiltrative anesthesia. Am Fam Physician, 2002, 66(1): 91-94.
14.	薛敏, 高冶, 段介君. 鹽酸甲哌卡因/腎上腺素注射液與鹽酸利多卡因注射液在拔牙術中的麻醉效果比較. 內蒙古醫學雜志, 2016, 48(4): 470-471.
15.	陳杰, 那冬鳴, 申英末, 等. 局部神經阻滯麻醉在腹股溝無張力疝修補術中的應用. 中華普通外科雜志, 2005, 20(2): 107-108.
16.	馮琦琛, 王昌明, 李選, 等. 超聲引導下腔內射頻閉合術聯合局部點剝治療下肢靜脈曲張. 中國微創外科雜志, 2018, 18(7): 577-580.
17.	熊建明, 黃建華, 盧伶俐. 射頻閉合治療大隱靜脈曲張 96 例臨床分析. 臨床和實驗醫學雜志, 2010, 9(9): 651-652.
18.	Guptan RC. Regarding “Is there an increased risk for DVT with VNUS closure procedure?”. J Vasc Surg, 2003, 38(5): 1140.
19.	單平, 李鳴, 金煒, 等. 射頻閉合與傳統剝脫術治療下肢靜脈曲張的對照研究. 中華普通外科雜志, 2006, 21(2): 92-94.
20.	汪濤, 何旭, 顧建平, 等. 腔內射頻閉合治療下肢靜脈曲張的應用. 中國醫學影像技術, 2008, 24(2): 267-269.
21.	朱曉銘, 李亮, 唐曉勇, 等. 射頻閉合術治療大隱靜脈曲張的臨床觀察. 甘肅醫藥, 2018, 37(4): 333-334.
22.	王深明, 武日東. 中國下肢淺靜脈曲張微創治療的發展現狀. 中華普通外科學文獻: 電子版, 2015, 9(1): 1-4.
23.	朱化剛, 邵擁軍, 周靜, 等. 美國下肢靜脈曲張及慢性靜脈疾病治療指南解讀. 中華普通外科雜志, 2012, 27(3): 258-259.
24.	盛麗, 霍樹靚, 李亮, 等. 超聲監視引導下行射頻閉合術治療大隱靜脈曲張臨床觀察. 西部中醫藥, 2014, 27(9): 159-161.
25.	邵長剛, 王斌, 遲國慶, 等. 大隱靜脈射頻消融術療效分析. 中國醫刊, 2019, 54(8): 887-890.
26.	Morrison N. Saphenous ablation: what are the choices, laser or RF energy. Semin Vasc Surg, 2005, 18(1): 15-18.

1. 中華醫學會外科分會血管外科學組. 慢性下肢靜脈疾病診斷與治療中國專家共識. 中華普通外科雜志, 2014, 29(4): 246-252.
2. 宋均飛, 殷世武. 大隱靜脈曲張微創治療進展. 安徽醫藥, 2019, 23(3): 437-440.
3. Ogawa T, Hoshino S, Midorikawa H, et al. Clinical results of radiofrequency endovenous obliteration for varicose veins. Surg Today, 2005, 35(1): 47-51.
4. Winterborn R. Randomized clinical trial of VNUS ClosureFAST radiofrequency ablation versus laser for varicose veins (Br J Surg 2010; 97: 810- 818). Br J Surg, 2010, 97(6): 818-819.
5. 孫麗娜, 覃文, 錢立友, 等. 大隱靜脈射頻消融閉合術治療大隱靜脈曲張的臨床分析. 醫學理論與實踐, 2019, 32(13): 2052-2054.
6. Marsh P, Price BA, Holdstock J, et al. Deep vein thrombosis (DVT) after venous thermoablation techniques: rates of endovenous heat-induced thrombosis (EHIT) and classical DVT after radiofrequency and endovenous laser ablation in a single centre. Eur J Vasc Endovasc Surg, 2010, 40(4): 521-527.
7. 李亮, 朱曉銘, 唐曉勇, 等. 360 例下肢靜脈性潰瘍個體化治療的臨床分析. 中國普外基礎與臨床雜志, 2016, 23(5): 590-593.
8. Nicolini P, Closure Group. Treatment of primary varicose veins by endovenous obliteration with the VNUS closure system: results of a prospective multicentre study. Eur J Vasc Endovasc Surg, 2005, 29(4): 433-439.
9. Puggioni A, Marks N, Hingorani A, et al. The safety of radiofrequency ablation of the great saphenous vein in patients with previous venous thrombosis. J Vasc Surg, 2009, 49(5): 1248-1255.
10. Schmedt CG, Meissner OA, Hunger K, et al. Evaluation of endovenous radiofrequency ablation and laser therapy with endoluminal optical coherence tomography in an ex vivo model. J Vasc Surg, 2007, 45(5): 1047-1058.
11. Kundu S, Achar S. Principles of office anesthesia: part Ⅱ. Topical anesthesia. Am Fam Physician, 2002, 66(1): 99-102.
12. 吳孟超, 吳在德. 黃家駟外科學. 第 7 版. 北京: 人民衛生出版社, 2008: 295.
13. Achar S, Kundu S. Principles of office anesthesia: part Ⅰ. Infiltrative anesthesia. Am Fam Physician, 2002, 66(1): 91-94.
14. 薛敏, 高冶, 段介君. 鹽酸甲哌卡因/腎上腺素注射液與鹽酸利多卡因注射液在拔牙術中的麻醉效果比較. 內蒙古醫學雜志, 2016, 48(4): 470-471.
15. 陳杰, 那冬鳴, 申英末, 等. 局部神經阻滯麻醉在腹股溝無張力疝修補術中的應用. 中華普通外科雜志, 2005, 20(2): 107-108.
16. 馮琦琛, 王昌明, 李選, 等. 超聲引導下腔內射頻閉合術聯合局部點剝治療下肢靜脈曲張. 中國微創外科雜志, 2018, 18(7): 577-580.
17. 熊建明, 黃建華, 盧伶俐. 射頻閉合治療大隱靜脈曲張 96 例臨床分析. 臨床和實驗醫學雜志, 2010, 9(9): 651-652.
18. Guptan RC. Regarding “Is there an increased risk for DVT with VNUS closure procedure?”. J Vasc Surg, 2003, 38(5): 1140.
19. 單平, 李鳴, 金煒, 等. 射頻閉合與傳統剝脫術治療下肢靜脈曲張的對照研究. 中華普通外科雜志, 2006, 21(2): 92-94.
20. 汪濤, 何旭, 顧建平, 等. 腔內射頻閉合治療下肢靜脈曲張的應用. 中國醫學影像技術, 2008, 24(2): 267-269.
21. 朱曉銘, 李亮, 唐曉勇, 等. 射頻閉合術治療大隱靜脈曲張的臨床觀察. 甘肅醫藥, 2018, 37(4): 333-334.
22. 王深明, 武日東. 中國下肢淺靜脈曲張微創治療的發展現狀. 中華普通外科學文獻: 電子版, 2015, 9(1): 1-4.
23. 朱化剛, 邵擁軍, 周靜, 等. 美國下肢靜脈曲張及慢性靜脈疾病治療指南解讀. 中華普通外科雜志, 2012, 27(3): 258-259.
24. 盛麗, 霍樹靚, 李亮, 等. 超聲監視引導下行射頻閉合術治療大隱靜脈曲張臨床觀察. 西部中醫藥, 2014, 27(9): 159-161.
25. 邵長剛, 王斌, 遲國慶, 等. 大隱靜脈射頻消融術療效分析. 中國醫刊, 2019, 54(8): 887-890.
26. Morrison N. Saphenous ablation: what are the choices, laser or RF energy. Semin Vasc Surg, 2005, 18(1): 15-18.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

The clinical application of ultrasound-guided local anesthesia in radionfrequency endovenous obliteration in treatment of great saphenous vein varices

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