天津医药

天津医药 ›› 2026, Vol. 54 ›› Issue (6): 643-646.doi: 10.11958/20260228

• 应用研究 • 上一篇    下一篇

超声引导下股鞘内浸润麻醉在腹主动脉瘤腔内修复术中的应用

吕路(), 朱杰昌△(), 王峥, 秘家学   

  1. 天津医科大学总医院血管外科 （邮编300052）
  • 收稿日期:2026-01-26 修回日期:2026-02-28 出版日期:2026-06-15 发布日期:2026-06-15
  • 通讯作者: △E-mail：cap1321@126.com
  • 作者简介:吕路（1978），女，主管护师，主要从事外周血管疾病方面研究。E-mail：15822962376@163.com
  • 基金资助:
    天津市卫生健康科技项目(TJWJ2025ZK003)

Ultrasound-guided infiltration anesthesia with the femoral sheath during endovascular aneurysm repair surgery

LYU Lu(), ZHU Jiechang△(), WANG Zheng, BI Jiaxue   

  1. Department of Vascular Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China
  • Received:2026-01-26 Revised:2026-02-28 Published:2026-06-15 Online:2026-06-15
  • Contact: △E-mail：cap1321@126.com

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摘要：

目的 比较超声引导下股鞘内浸润麻醉（IAFS）和超声引导下皮下局部浸润麻醉（LIA）在经股总动脉（CFA）入路行腹主动脉瘤腔内修复术（EVAR）中的镇痛效果，并评估两者的安全性及有效性。方法 选取2017年1月——2020年12月在局部麻醉下经CFA行EVAR的256例患者并分为IAFS组和LIA组，LIA组包含116例患者的232次股总动脉（CFA）穿刺置鞘，IAFS组包含140例患者的276次CFA穿刺置鞘。对比2组间技术成功率、麻醉时间、麻醉剂用量、手术期间的疼痛视觉模拟量表（VAS）评分以及中转全身麻醉的比例。结果 LIA组和IAFS组技术成功率（100.0% vs. 99.3%），麻醉时间[（17.88±1.49）s vs. （18.14±1.82）s]差异均无统计学意义（P>0.05）。IAFS组使用的麻醉剂用量少于LIA组[（17.71±1.16）mL vs. （22.72±2.38）mL，P<0.01]。在覆膜支架输送系统或大口径鞘管经CFA置入过程中，IAFS组疼痛VAS评分显著低于LIA组[（1.23±0.90）分vs. （2.38±1.30）分，P<0.01]。LIA组和IAFS组转为全身麻醉的比例差异无统计学意义（6.9% vs. 2.9%，P>0.05）。结论 LIA和IAFS在EVAR中均安全有效，但IAFS较LIA更能显著减轻患者疼痛感。

关键词: 麻醉, 局部, 股动脉, 腔内修复术, 超声引导穿刺

Abstract:

Objective To compare the analgesic efficacy and safety of the ultrasound-guided infiltration anesthesia with the femoral sheath (IAFS) and local infiltration anesthesia (LIA) for femoral arterial access gain during endovascular aneurysm repair (EVAR) surgery. Methods A total of 256 patients who underwent EVAR via common femoral artery (CFA) under local anesthesia from January 2017 to December 2020 were retrospectively analyzed and divided into the IAFS group and the LIA group. The LIA group included 232 CFA punctures and sheath placement in 116 patients, and the IAFS group included 276 CFA punctures and sheath placement in 140 patients. The analgesic effect of IAFS and LIA in EVAR was analyzed. The technical success rate, anesthesia duration, volume of anesthetics, pain visual-analogue scale (VAS score 0-10) during operation and conversion to general anesthesia were compared between the two groups. Results There were no significant differences in technical success (100.0% vs. 99.3%) and the anesthesia time [(17.88±1.49) s vs. (18.14±1.82) s] between the LIA group and the IAFS group (P>0.05). The volume of anesthetic solution used in the IAFS group was significantly less compared to the LIA group [(17.71±1.16) mL vs. (22.72±2.38) mL, P<0.01]. The pain scores during the advancement of the delivery system or a larger profile sheath were significantly lower in the IAFS group compared to the LIA group (1.23±0.90 vs. 2.38±1.30, P<0.01). There was no significant difference in conversion to general anesthesia between the two groups (6.9% vs. 2.9%, P>0.05). Conclusion Both LIA and IAFS are safe during EVAR, but IAFS can significantly reduce patients' pain more than LIA.

Key words: anesthesia, local, femoral artery, endovascular aneurysm repair, ultrasound-guided puncture

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