Comparing local tumescent anesthesia and spinal anesthesia methods during and after endovenous radiofrequency ablation of great saphenous vein

Bitargil, Macit; Kılıç, Helin El

doi:10.23736/s0392-9590.20.04414-4

Cited by 6 publications

(5 citation statements)

References 17 publications

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“…We believe these cases can be done with tumescence anesthesia alone, but spinal anesthesia showed significantly lower pain scores compared to tumescence alone. 24 Our patients already experienced pain related to their VLU so we assumed it would be better to minimize their pain-related procedure with the choice of spinal anesthesia despite the longer preparation time and spinal anesthesia-related complications which fortunately didn't happen in our patients.…”

Section: Discussionmentioning

confidence: 93%

Satisfactory result of great saphenous vein endovenous laser ablation until below the knee on active venous leg ulcer: a case series

Taofan,

Dakota,

Kartamihardja

et al. 2024

F1000Res

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Background Active venous leg ulcer (VLU) is the most severe manifestation of chronic venous disease which not only affects patients’ health, but also decreases the quality of life, and delivers economic burdens. Treatment of superficial venous reflux with early endovenous laser ablation (EVLA) has been associated with reducing ulcer recurrence levels and promoting faster VLU healing. We reported three cases of patients with active VLU undergoing EVLA with different approaches. Case illustration Three patients came with complaint of leg ulcer, diagnosed with C6sEpAsdPr, with venous clinical severity scores (VCSS) of 15, 23, and 22 respectively. Severe great saphenous veins (GSV) reflux was found in all patients by duplex ultrasound examination. The second patient had undergone above-the-knee EVLA. All patients underwent EVLA using 1470-nano meter wavelength laser device and ELVeS radial fiber (Biolitec, Bonn, Germany). The laser energy protocol used was 6 W linear endovenous energy density (LEED) 50 J/cm for proximal until media ATK GSV ablation, 5 W LEED 40 J/cm for media ATK until proximal below-the-knee (BTK) GSV, and 2 W LEED 20 J/cm for proximal until distal BTK GSV. The third patient was also treated with EVLA for small saphenous vein severe reflux. Follow-up until 6 months post-EVLA showed significant healing of the ulcer with 14, 16, and 17 VCSS reduction consecutively without any complication. Conclusion We’ve reported three cases of patients with active VLU undergoing EVLA until BTK with significant results. The EVLA of GSV until BTK where there is still significant reflux is safe and provides satisfactory results in patients with VLU.

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Section: Discussionmentioning

confidence: 93%

Satisfactory result of great saphenous vein endovenous laser ablation until below the knee on active venous leg ulcer: a case series

Taofan,

Dakota,

Kartamihardja

et al. 2024

F1000Res

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“…Similarly, AVVQ scores significantly declined in both groups from the first month onward, with no difference between the groups at any point in time. The AVVQ declined from baseline (median [IQR], 18 [16][17][18][19][20]) to 12 weeks (median [IQR], 7 [5][6][7][8]) (p < 0.001) in the CA group and from baseline (median [IQR], 19 [17][18][19][20]) to 12 weeks (median [IQR], 12 [10][11][12][13]) (p < 0.001) in the EVLA group (Figure 3).…”

Section: Resultsmentioning

confidence: 99%

“…6,7 Tumescent anesthesia is generally effective and well tolerated but requires multiple needle punctures along the truncal vein pathway, which contributes to significant procedural duration as well as discomfort. 8 Since the application of cyanoacrylate glue was first reported by Almeida et al in 2013, 9 cyanoacrylate ablation (CA) has generally been considered a new nonthermal, nontumescent method that has emerged to improve the patient's experience and eliminate the side effects of endovenous thermal ablation. 10 Previous long-term follow-up studies have shown that CA is safe and effective in blocking the truncal vein and is not inferior to the current mainstream treatment methods, but the evidence is principally based on a white patient-biased cohort.…”

Section: Introductionmentioning

confidence: 99%

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Early results of cyanoacrylate adhesive ablation versus laser ablation for the treatment of great saphenous vein insufficiency in the Chinese mainland population

Zhang

et al. 2023

Phlebology

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Objective In this study, we present our early outcomes of cyanoacrylate ablation (CA) versus endovenous laser ablation (EVLA) for the treatment of great saphenous vein (GSV) insufficiency in the Chinese mainland population. Methods We retrospectively analyzed 108 patients (53 patients in the CA group and 55 patients in the EVLA group) with GSV insufficiency who were treated with CA and EVLA between May 2020 and May 2021. The Venous Clinical Severity Score and Aberdeen Varicose Vein Questionnaire were used to assess clinical symptoms and quality of life, respectively. Total closure rates and procedure-related adverse events were also recorded in both groups. Results There was no significant difference between patients treated with CA or EVLA in terms of demographic and clinical characteristics. The average procedure time was 17 min in the CA group and 35 min in the EVLA group ( p < 0.001). The CA group had lower pain scores during the procedure and 3 days afterward than the EVLA group ( p < 0.001). At month 12, the CA group had a 90.4% closure rate, while the EVLA group had an 83.0% closure rate, with no significant difference between the two groups ( p > 0.05). There was no significant difference in the Venous Clinical Severity Score or Aberdeen Varicose Vein Questionnaire score between the groups ( p > 0.05). During follow-up, neither group experienced any significant adverse events, such as pulmonary embolism or deep venous thrombosis. The incidence of ecchymosis and paresthesia was significantly lower in the CA group than in the EVLA group ( p < 0.05). Conclusions Cyanoacrylate ablation has a high feasibility profile and is an effective approach to accomplish complete GSV target vein closure at early follow-up in the Chinese patients. Compared to EVLA, the improvement in quality-of-life outcomes is also sustained and similar, with less pain and fewer complications due to the absence of tumescence anesthesia and postprocedural compression stockings.

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“…[2,3] The process can be performed under lumbar, local, and sedation anesthesia. [4] Topical anesthesia causes less anesthesia-related pain and discomfort in patients. This method has been widely used in some surgeries, especially cataract surger.…”

Section: Introductionmentioning

confidence: 99%

Comparison of oxybuprocaine and lidocaine topical anesthesia for pain control in radiofrequency ablation treatment of great saphenous vein insufficiency

Yan,

Liu,

Chen

2023

Medicine

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Topical anesthetics have been used for radiofrequency ablation of great saphenous vein insufficiency. A total of 74 patients with great saphenous vein insufficiency treated at our center between February 2021 and August 2022 were enrolled. The patients were selected and divided into an oxybuprocaine group(n = 30) and a lidocaine group (n = 44). The visual analogue scale (VAS) was used to evaluate intraoperative and postoperative pain. Patient satisfaction with anesthesia, maintenance time of anesthesia, and disturbance of the surgeons were also recorded and assessed. The VAS scores and other indices of the 2 groups were compared to assess the effectiveness of anesthesia. Perioperative surgical complications and painkiller use were also recorded. The median VAS score of the patients during the process was 2 in both groups, and the difference between the groups was not statistically significant. In the 2 groups, 93.33% of the patients in the oxybuprocaine group and 93.18% of the patients in the lidocaine group were satisfed with the anesthesia. Nine patients in the lidocaine group and 14 in the oxybuprocaine group received additional anesthetic drugs. The average maintenance time of anesthesia was longer in the lidocaine group. No serious complications occurred in either of the groups. Both oxybuprocaine and lidocaine topical anesthesia combined with tumescent anesthesia could provide effective pain control in radiofrequency ablation treatment of great saphenous vein insufficiency. Although the average maintenance time of anesthesia was longer in the lidocaine group, there was no difference in the associated complications and pain control.

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Comparing local tumescent anesthesia and spinal anesthesia methods during and after endovenous radiofrequency ablation of great saphenous vein

Cited by 6 publications

References 17 publications

Satisfactory result of great saphenous vein endovenous laser ablation until below the knee on active venous leg ulcer: a case series

Satisfactory result of great saphenous vein endovenous laser ablation until below the knee on active venous leg ulcer: a case series

Early results of cyanoacrylate adhesive ablation versus laser ablation for the treatment of great saphenous vein insufficiency in the Chinese mainland population

Comparison of oxybuprocaine and lidocaine topical anesthesia for pain control in radiofrequency ablation treatment of great saphenous vein insufficiency

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