Application Status of Tumescent Anesthesia in the Treatment of Lower Extremity Varicose Veins with Thermal Ablation

下肢静脉曲张通常指在各种因素作用下，引起的下肢浅静脉迂曲、扩张，可同时伴下肢酸胀、乏力及沉着感等功能异常症状，晚期可出现脂质硬化、慢性溃疡等病变，是血管外科最常见的一种疾病。目前该疾病仍以手术治疗为主，热消融术是腔内微创手术治疗下肢静脉曲张中的代表，具有创伤小、可控性高、疗效满意等优势，被许多临床指南推荐为首选治疗方式。在热消融手术广泛应用的背景下，如何减少术中疼痛、提高手术效率、减少术后并发症，仍是很多医生面临的难题。肿胀麻醉在热消融术治疗下肢静脉曲张中的使用效果显著，但其成分、使用方式、运用时机等仍存在较大的探索空间。本文就肿胀麻醉在下肢静脉曲张射频消融术中的应用现状进行综述。Lower extremity varicose veins (LEVV) typically refer to the tortuosity and dilation of superficial veins caused by multiple etiological factors, often accompanied by functional abnormalities such as lower limb soreness, fatigue, and heaviness. Advanced stages may manifest pathological changes including lipodermatosclerosis and chronic ulcers, making it the most prevalent condition in vascular surgery. Surgical intervention remains the mainstay treatment, with thermal ablation emerging as the representative endovenous minimally invasive technique. Recognized for its minimal invasiveness, high controllability, and satisfactory therapeutic outcomes, this modality has been recommended as the primary treatment option by numerous clinical guidelines. However, despite its widespread application, challenges persist in reducing intraoperative pain, enhancing surgical efficiency, and minimizing postoperative complications. Tumescent anesthesia has demonstrated significant efficacy in thermal ablation procedures for LEVV, yet substantial exploration is still required regarding its optimal composition, administration methods, and timing during intervention. This review comprehensively examines current applications of tumescent anesthesia in radiofrequency ablation for lower extremity varicose veins and discusses potential avenues for clinical optimization.