目的：探讨超声导入肿胀麻醉液(肿麻液)对腔内激光治疗下肢静脉曲张术后疼痛的影响。方法：90例下肢静脉曲张患者随机分为研究组和对照组, 每组45例, 研究组在超声导引下行肿麻液注入辅助腔内激光消融治疗; 对照组在超声导引下行传统硬膜外麻醉辅助腔内激光消融治疗。比较两组临床疗效、神经阻滞情况、围术期心率(HR)和平均动脉压(MAP)、术后视觉模拟评分(VAS)以及术后日常活动恢复情况。结果：①研究组治疗总有效率为91.11%, 高于对照组的86.67%, 但两组临床疗效比较差异无统计学意义(P＞0.05)。②研究组神经阻滞起效时间短于对照组(P＜0.05), 研究组5、10、15 min神经阻滞评分高于对照组(P＜0.05), 两组神经阻滞成功率无统计学差异(P＞0.05)。③两组患者手术开始时及术后15、30 min 时HR较术前下降(P＜0.05), MAP较术前升高(P＜0.05), 但两组间不同时点HR及MAP比较, 差异均无统计学意义(P＞0.05)。④两组术后麻醉恢复时 VAS 评分无统计学差异, 但研究组术后2、4、6、8 h VAS 评分低于对照组(P＜0.05)。⑤研究组术后1d、2d、3d日常活动恢复比例均大于对照组(P＜0.05)。结论：在腔内激光消融治疗下肢静脉曲张过程中使用肿麻液能够比传统硬脊膜外腔阻滞麻醉更好地减轻术后疼痛。

Objective: To observe the effect of ultrasound-guided tumescence anesthesia solution on postoperative pain of endovenous laser ablation of lower extremity varicose vein. Methods: 90 cases of patients with lower extremity varicose vein were divided randomly into study group and control group, 45 cases in each group, two groups were treated by endovenous laser ablation, study group was assisted by ultrasound-guided tumescence anesthesia solution, and control group was assisted by traditional epidural anesthesia. Clinical efficacy, nerve block, perioperative heart rate (HR) and mean arterial pressure (MAP), postoperative visual analogue score (VAS) and postoperative recovery of daily activities were compared between the two groups. Results: ①The total effective rate in the study group was 91.11%, higher than that in the control group (86.67%), but there was no statistically significant difference in clinical efficacy between the two groups (P>0.05).②The onset time of nerve block in the study group was shorter than that in the control group (P<0.05), and the score of nerve block in the study group at 5, 10 and 15 minutes was higher than that in the control group (P<0.05). There was no statistical difference in the success rate of nerve block between the two groups (P>0.05).③At the beginning of the operation and 15, 30 min after the operation, HR in the two groups was lower than that before the operation (P<0.05), and MAP was higher than that before the operation (P<0.05), but the differences in HR and MAP at different time points between the two groups were not statistically significant (P>0.05).④There was no statistically significant difference in VAS score at postoperative anesthesia recovery between the two groups, but VAS scores at 2, 4, 6, and 8 h after surgery in the study group were lower than those in the control group (P<0.05).⑤The recovery rates of daily activities in the study group at 1 d, 2 d and 3d after surgery were all higher than those in the control group (P<0.05). Conclusion: The use of tumescence anesthesia solution in the treatment of lower extremity varicose veins by intracavitary laser can alleviate postoperative pain better than traditional epidural block anesthesia.