Endovenous Laser Ablation under General Anesthesia for Day Surgery: Feasibility and Outcomes of the 300 Patients

Arun, Oğuzhan; Öç, Bahar; Duman, Ateş; Yıldırım, Serkan; Şimşek, Murat; Farsak, Bora; Öç, Mehmet

doi:10.5761/atcs.oa.13-00222

Cited by 10 publications

(7 citation statements)

References 24 publications

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“…Spinal anesthesia is a crucial choice to avoid pain, stress, and discomfort. 1,14,15 Unfortunately, potential risks of headache, vomiting, urinary retention, delayed mobilization, increased risk of deep vein thrombosis are present. But we think some methods such as using smaller needles or using pencil-point needles instead of sharp needles can lower side effects.…”

Section: Discussionmentioning

confidence: 99%

“…Spinal anesthesia is commonly used for anesthesia and/ or analgesia for varicose vein operations, and its use is still prevalent. 1 The aim of any vascular intervention against chronic venous insufficiency is to increase the patient's quality of life. Discharging the patient without pain and complications back to their health in the quickest way was one of the main ideas behind spinal anesthesia usage.…”

Section: Introductionmentioning

confidence: 99%

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Our experience regarding patients with headache, vomiting, and urinary retention following endothermal ablation of the greater saphenous vein under spinal anesthesia: Gender type, age interval, and procedural risk factors are important

Bitargil

Kılıç

2020

Vascular

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Objectives The endovenous thermal ablation of the greater saphenous vein under spinal anesthesia is still a popular technique. Although this procedure is considered to be fast and simple, side effects such as headaches, vomiting, and urinary retention could occur. These side effects make the recovery period difficult for the patient. The patient’s age, gender, and procedural risk factors such as needle sizes and types are important parameters that affect the occurrence and rate of undesirable outcomes. This retrospective study aims to evaluate the endovenous thermal ablation method for the management of incompetent great saphenous veins under spinal anesthesia. Methods A total of 128 patients with incompetent varicose veins who were treated with an endovenous thermal ablation method under spinal anesthesia were retrospectively investigated between January 2016 and January 2019. The pre-, intra-, post-procedural, and follow-up data of the patients were collected and retrospectively compared. Results A total of 128 patients (69 males, 59 females; mean age 45.8 ± 11.8 years; range 21–71 years) were included in the study. The average preprocedural great saphenous vein diameters were 7.41 ± 18.8 mm (range: 5.5–13.0). The average ablated vein length was 25.3 ± 3.4 (range: 15–35) cm. The average tumescent anesthesia use was 300.9 ± 52.6 (range: 150–500) mL. The average procedure time was 18.2 ± 1.8 (range: 11–25) min. The venous clinical severity scores and the chronic venous insufficiency quality of life questionnaire scores declined significantly ( p for venous clinical severity scores: 0.001, p for chronic venous insufficiency quality of life questionnaire scores: 0.001). There was no postoperative paresis or paresthesia. There was one case of deep venous thrombosis and three cases of bruising. The total of three months’ occlusion rates was 96.9% (124/128). The overall post-dural puncture headache ratio was 18%. Women significantly suffered from more headaches than men (27% vs. 10%, p = 0.013). The extreme age intervals (pertaining to ages between 18 and 30 or 50+) were almost significantly less affected by headaches in comparison to the group with the age interval between 31 and 50 (11.3%, 24.2%, p: 0.056). A percentage of 12.5 patients suffered from vomiting. It was recorded that female patients suffered from vomiting more so than the males (20.3%, 5.8%, p: 0.013). Pertaining to vomiting, there was no significant difference between the two age interval groups ( p: 0.14). Urinary retention was observed in 6.3% of the patients. The female gender had a higher ratio of urinary retention, but the difference was insignificant. (8.5%, 4.3%, p: 0.46). There was no significant difference between the age interval groups in terms of urinary retention. Conclusions The endovenous thermal ablation of the greater saphenous vein under spinal anesthesia is a fast and effective treatment option for the management of incompetent saphenous veins. However, side effects such as headaches, vomiting, and urinary retention that are affected by gender types, age-intervals, and procedural characteristics should be kept in mind.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Our experience regarding patients with headache, vomiting, and urinary retention following endothermal ablation of the greater saphenous vein under spinal anesthesia: Gender type, age interval, and procedural risk factors are important

Bitargil

Kılıç

2020

Vascular

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“…Thus, manual bagging by an anesthesiologist could be used and, occasionally, an airway device, such as intubation or supraglottic airway (laryngeal mask airway) may be necessary to maintain the upper airway. However, in our hospital, manual assist under deep sedation would be preferred, to avoid general anesthesia and intubation and the disadvantages of these devices, including sore throat, possible risk of laryngospasm, and higher costs [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…Great or small saphenous vein stripping is a commonly performed surgical procedure as a treatment for varicose veins of the lower extremity. There are several anesthetic methods, including general anesthesia, neuraxial block, and peripheral nerve blocks, such as femoral nerve block, popliteal nerve block, and posterior cutaneous nerve block [ 1 2 3 4 ]. Monitored anesthesia care (MAC) with local anesthesia is another option for patients undergoing vein stripping.…”

Section: Introductionmentioning

confidence: 99%

Monitored anesthesia care for great saphenous vein stripping surgery with target controlled infusion of propofol and remifentanil: a prospective study

Cho

Han

Baik

et al. 2016

Korean J Anesthesiol

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BackgroundThe aim of this study was to determine the appropriate target concentrations at the effect site of propofol and remifentanil when deep sedation was achieved by monitored anesthesia care (MAC) anesthesia and related respiratory depression during vein stripping surgery for varicose veins.MethodsIn total, 51 adult patients who were scheduled for varicose vein stripping surgery were sedated with propofol and remifentanil during the surgery, after administration of midazolam. Target concentrations at the effect site of the two drugs were changed based on the patient's status. Respiratory support was applied in the order of oxygen supply, chin lift, and assisted mask ventilation. Target concentrations at the effect site of propofol and remifentanil, the need for respiratory support, and a six-point rating scale satisfaction score were the outcome measurements.ResultsOnly one patient did not require oxygen, eight patients needed oxygen alone, 22 patients required use of the chin lift technique, and 20 patients were assisted with mask ventilation. There was no significant difference in the target concentration of propofol or remifentanil between the patients who required mask ventilation and those who did not. Fifty of the 51 patients reported a satisfaction score of 6.ConclusionsAlthough MAC using low target concentrations of propofol and remifentanil during vein stripping surgery was satisfactory to patients, close observation regarding the need for respiratory assistance was necessary.

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“…Appropriate anesthesia techniques include general anesthesia with a laryngeal mask airway (LMA), spinal anesthesia, epidural anesthesia, femoral nerve block, and tumescent local anesthesia. [5][6][7][8] The key components of anesthesia for outpatient procedures are the use of short-acting anesthetic agents and rapid patient recovery. Outpatient procedures are usually performed under general anesthesia, sedation, or regional anesthesia.…”

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confidence: 99%

Spinal anesthesia versus general anesthesia with a laryngeal mask airway in patients undergoing radiofrequency ablation for varicose veins

Lafçı¹

2017

Turk Gogus Kalp Dama

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ÖZAmaç: Bu çalışmada variköz ven nedeniyle radyofrekans ablasyon yapılan hastalarda spinal anestezi ve larengeal maske hava yolu ile genel anestezinin etkinliği karşılaştırıldı.Ça lış ma pla nı: Mayıs 2012-Aralık 2016 tarihleri arasında larengeal maske hava yolu ile genel anestezi veya spinal anestezi altında radyofrekans ablasyon, varislerin çıkarılması ve perforan ven bağlanması yapılan toplam 2999 hasta (1067 erkek, 1932 kadın; ort. yaş 43 yıl; dağılım 19-70 yıl) retrospektif olarak incelendi. Hastanede yatış süresi, ameliyat sonrası Görsel Analog Ölçeği (GAÖ) skorları, hasta memnuniyeti, bulantı, kusma, boğaz ağrısı, baş ağrısı, sırt ağrısı ve üriner retansiyon dahil olmak üzere tıbbi kayıtlar kullanılarak veriler kaydedildi. Bul gu lar:Hastaların 2512'sine larengeal maske hava yolu ile genel anestezi ve 487'sine spinal anestezi uygulandı. Ortalama hastanede yatış süresi genel anestezi grubunda 10.7 saat ve spinal anestezi grubunda 22.5 saat idi ve bu fark istatistiksel olarak anlamlı idi (p<0.001). Ameliyat sonrası birinci saatteki ağrı skorları spinal anestezi grubuna kıyasla genel anestezi grubunda daha yüksekti (0.1±0.1 cm'ye kıyasla 1.7±0.1 cm) (p<0.001). Hasta memnuniyeti genel anestezi grubunda, spinal anestezi grubuna kıyasla, daha yüksekti (%92'ye kıyasla %97) (p<0.001). Kusma insidansı genel anestezi grubunda yüksek iken, bulantı, baş ağrısı ve üriner retansiyon insidansı spinal anestezi grubunda daha yüksek idi (tümü için p<0.001).So nuç: Radyofrekans ablasyon sırasında larengeal maske hava yolu, spinal anesteziye kıyasla, hastaların erken taburcu olmasını sağlar ve hasta memnuniyetini artırır; ancak kusma ve boğaz ağrısı gibi yan etkiler görülebilir. Spinal anestezi ameliyat sonrası ağrının azalması ile larengeal maske hava yolu ile genel anesteziden daha ilişkili olmasına karşın, bulantı, baş ağrısı ve üriner retansiyona neden olabilir.Anah tarsöz cük ler: Larengeal maske hava yolu; radyofrekans ablasyon; spinal anestezi. ABSTRACTBackground: This study aims to compare the efficacy of spinal anesthesia and general anesthesia with a laryngeal mask airway in patients undergoing radiofrequency ablation for varicose veins.

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Endovenous Laser Ablation under General Anesthesia for Day Surgery: Feasibility and Outcomes of the 300 Patients

Cited by 10 publications

References 24 publications

Our experience regarding patients with headache, vomiting, and urinary retention following endothermal ablation of the greater saphenous vein under spinal anesthesia: Gender type, age interval, and procedural risk factors are important

Our experience regarding patients with headache, vomiting, and urinary retention following endothermal ablation of the greater saphenous vein under spinal anesthesia: Gender type, age interval, and procedural risk factors are important

Monitored anesthesia care for great saphenous vein stripping surgery with target controlled infusion of propofol and remifentanil: a prospective study

Spinal anesthesia versus general anesthesia with a laryngeal mask airway in patients undergoing radiofrequency ablation for varicose veins

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