Anesthetic Effect Of Ultrasound-guided Anterior Lumbar Plexus Combined With Sciatic Nerve Block In High Ligation And Stripping Of Great Saphenous Vein

Objective:To observe the anesthetic effect of ultrasound-guided anterior lumbar plexus combined with sciatic nerve block in unilateral high ligation and stripping of great saphenous vein.Methods:This study was a prospective,randomized,controlled,single-blind study.Sixty patients,34 males and 26 females,aged 30-80 years old,BMI 18-30kg/m2,ASAⅠ-Ⅲ,were selected and randomly divided into two groups: ultrasound-guided anterior lumbar plexus combined with sciatic nerve block group(group N)and lumbar anesthesia group(group E),with 30 patients in each group.Group N received ultrasound-guided anterior lumbar plexus block combined with sciatic nerve block,first with 0.375% ropivacaine15 ml for sciatic nerve block,and then with 0.375% ropivacaine 35 ml for anterior lumbar plexus block.Group E underwent lumbar anesthesia and was given 0.67% ropivacaine 2.5～ 3m L.The resting visual analogue scale(VAS)of the two groups were observed and recorded after entry(T0),15 minutes after anesthesia(T1),skin resection(T2),vein dissection(T3),finish the operation(T4),postoperative 4h(T5),8h(T6),12h(T7),and24h(T8).Additional sufentanil should be recorded.The cases of vasoactive drugs were recorded.Mean arterial pressure(MAP)and heart rate(HR)at T0,T1,T2,T3 and T4 were recorded.The surgeon’s satisfaction with the effect of anesthesia was recorded.The complications were recorded within 24 hours after operation.Results:Compared with T0,HR and MAP were decreased at T1 and T4 in group N,HR and MAP were decreased at T1 and T4 in group E,and heart rate was accelerated at T2.The resting VAS score of T1-T8 was decreased in both groups(P<0.05),and the difference at other time points was not statistically significant.Compared with group E,HR was accelerated at T1 and T3,MAP was increased at T1 and T4,and resting VAS score was significantly decreased at T5-T7 in group N(P<0.05).There was no statistically significant difference at the remaining time points.The number of cases of ephedrine and anisodamine in group N decreased significantly,and the satisfaction degree of operation was higher than that in group E.There were no significant differences in sufentanil supplemental amount and postoperative complications 24 h between the two groups(P>0.05).Conclusion:The application of anterior lumbar plexus combined with sciatic nerve block in unilateral high ligation and stripping of great saphenous vein has perfect analgesic effect,little influence on cardiovascular system,can meet the requirements of surgeons,and less postoperative adverse reactions,which is worth promoting in clinical practice.