Abstract
To compare the effects of ultrasound-guided tumescent local anaesthesia (TLA) and epidural anaesthesia (EA) in great saphenous vein stripping and to explore the feasibility of using TLA in this procedure. This study included 144 patients diagnosed with varicose veins of the great saphenous vein who required surgical treatment and were admitted to the Second People's Hospital affiliated with Fujian University of Traditional Chinese Medicine from March 2020 to November 2023. Patients were divided into two groups based on the anaesthesia method used, including the observation group (TLA) and the control group (EA), with 72 patients in each group. Both groups underwent high ligation, internal stripping, and microvenectomy of the great saphenous vein. Perioperative data were collected, and pain was assessed using the visual analogue scale (VAS) immediately after anaesthesia, immediately after surgery, 24 hours postsurgery, and 48 hours postsurgery. Intraoperative conditions, postoperative recovery, complications, and economic benefits were compared between the two groups. Compared with the control group, the observation group had lower VAS scores immediately after anaesthesia (3.6±1.4 vs. 4.5±1.7) and immediately after surgery (2.1±1.4 vs. 3.3±1.5) (P<0.05). Blood pressure fluctuations (113.8±9.8 vs. 120±8.9 mmHg) and heart rates (77.3±7.8 vs. 97.3±5.7 beats/min) during stripping were significantly lower in the control group (P<0.05). The observation group had a significantly shorter postoperative bed rest duration (45.5±11.9 vs. 93.6±13.8 min), postoperative urinary retention (0 vs. 6 patients), postoperative deep vein thrombosis (1 vs. 7 patients), total postoperative hospital stay (1.7±0.5 vs. 3.3±0.5 days), and hospitalization costs (¥7311.7±117.5 vs. ¥9234.3±87.5) (P<0.05). No significant differences were noted between the groups in terms of the VAS score at 24 and 48 hours postsurgery, operation time, postoperative nausea and vomiting, or incidence of postoperative incision infections (P>0.05). Ultrasound-guided tumescent local anaesthesia for great saphenous vein stripping reduces intraoperative pain, allows for earlier ambulation, and effectively minimizes postanaesthesia complications and deep vein thrombosis. This method enables quicker recovery and reduces hospitalization costs.
Published Version
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