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.	中华医学会外科分会血管外科学组. 慢性下肢静脉疾病诊断与治疗中国专家共识. 中华普通外科杂志, 2014, 29(4): 246-252.
2.	宋均飞, 殷世武. 大隐静脉曲张微创治疗进展. 安徽医药, 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.	孙丽娜, 覃文, 钱立友, 等. 大隐静脉射频消融闭合术治疗大隐静脉曲张的临床分析. 医学理论与实践, 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, 朱晓铭, 唐晓勇, 等. 360 例下肢静脉性溃疡个体化治疗的临床分析. 中国普外基础与临床杂志, 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.	吴孟超, 吴在德. 黄家驷外科学. 第 7 版. 北京: 人民卫生出版社, 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. 盐酸甲哌卡因/肾上腺素注射液与盐酸利多卡因注射液在拔牙术中的麻醉效果比较. 内蒙古医学杂志, 2016, 48(4): 470-471.
15.	陈杰, 那冬鸣, 申英末, 等. 局部神经阻滞麻醉在腹股沟无张力疝修补术中的应用. 中华普通外科杂志, 2005, 20(2): 107-108.
16.	冯琦琛, 王昌明, 李选, 等. 超声引导下腔内射频闭合术联合局部点剥治疗下肢静脉曲张. 中国微创外科杂志, 2018, 18(7): 577-580.
17.	熊建明, 黄建华, 卢伶俐. 射频闭合治疗大隐静脉曲张 96 例临床分析. 临床和实验医学杂志, 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.	单平, 李鸣, 金炜, 等. 射频闭合与传统剥脱术治疗下肢静脉曲张的对照研究. 中华普通外科杂志, 2006, 21(2): 92-94.
20.	汪涛, 何旭, 顾建平, 等. 腔内射频闭合治疗下肢静脉曲张的应用. 中国医学影像技术, 2008, 24(2): 267-269.
21.	朱晓铭, 李亮, 唐晓勇, 等. 射频闭合术治疗大隐静脉曲张的临床观察. 甘肃医药, 2018, 37(4): 333-334.
22.	王深明, 武日东. 中国下肢浅静脉曲张微创治疗的发展现状. 中华普通外科学文献: 电子版, 2015, 9(1): 1-4.
23.	朱化刚, 邵拥军, 周静, 等. 美国下肢静脉曲张及慢性静脉疾病治疗指南解读. 中华普通外科杂志, 2012, 27(3): 258-259.
24.	盛丽, 霍树靓, 李亮, 等. 超声监视引导下行射频闭合术治疗大隐静脉曲张临床观察. 西部中医药, 2014, 27(9): 159-161.
25.	邵长刚, 王斌, 迟国庆, 等. 大隐静脉射频消融术疗效分析. 中国医刊, 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. 中华医学会外科分会血管外科学组. 慢性下肢静脉疾病诊断与治疗中国专家共识. 中华普通外科杂志, 2014, 29(4): 246-252.
2. 宋均飞, 殷世武. 大隐静脉曲张微创治疗进展. 安徽医药, 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. 孙丽娜, 覃文, 钱立友, 等. 大隐静脉射频消融闭合术治疗大隐静脉曲张的临床分析. 医学理论与实践, 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, 朱晓铭, 唐晓勇, 等. 360 例下肢静脉性溃疡个体化治疗的临床分析. 中国普外基础与临床杂志, 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. 吴孟超, 吴在德. 黄家驷外科学. 第 7 版. 北京: 人民卫生出版社, 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. 盐酸甲哌卡因/肾上腺素注射液与盐酸利多卡因注射液在拔牙术中的麻醉效果比较. 内蒙古医学杂志, 2016, 48(4): 470-471.
15. 陈杰, 那冬鸣, 申英末, 等. 局部神经阻滞麻醉在腹股沟无张力疝修补术中的应用. 中华普通外科杂志, 2005, 20(2): 107-108.
16. 冯琦琛, 王昌明, 李选, 等. 超声引导下腔内射频闭合术联合局部点剥治疗下肢静脉曲张. 中国微创外科杂志, 2018, 18(7): 577-580.
17. 熊建明, 黄建华, 卢伶俐. 射频闭合治疗大隐静脉曲张 96 例临床分析. 临床和实验医学杂志, 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. 单平, 李鸣, 金炜, 等. 射频闭合与传统剥脱术治疗下肢静脉曲张的对照研究. 中华普通外科杂志, 2006, 21(2): 92-94.
20. 汪涛, 何旭, 顾建平, 等. 腔内射频闭合治疗下肢静脉曲张的应用. 中国医学影像技术, 2008, 24(2): 267-269.
21. 朱晓铭, 李亮, 唐晓勇, 等. 射频闭合术治疗大隐静脉曲张的临床观察. 甘肃医药, 2018, 37(4): 333-334.
22. 王深明, 武日东. 中国下肢浅静脉曲张微创治疗的发展现状. 中华普通外科学文献: 电子版, 2015, 9(1): 1-4.
23. 朱化刚, 邵拥军, 周静, 等. 美国下肢静脉曲张及慢性静脉疾病治疗指南解读. 中华普通外科杂志, 2012, 27(3): 258-259.
24. 盛丽, 霍树靓, 李亮, 等. 超声监视引导下行射频闭合术治疗大隐静脉曲张临床观察. 西部中医药, 2014, 27(9): 159-161.
25. 邵长刚, 王斌, 迟国庆, 等. 大隐静脉射频消融术疗效分析. 中国医刊, 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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