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

To compare the effect of cold or room temperature of tumescence anesthesia solution on pain perception during and after 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.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。.