Is the temperature of tumescent anesthesia applied in the endovenous laser ablation important? Comparison of different temperatures for tumescent anesthesia applied during endovenous ablation of incompetent great saphenous vein with a 1470 nm diode laser

Abud, Burçin; Karaarslan, Kemal; Turhan, Soysal; Karaman, Yücel

doi:10.1177/1708538113518532

Cited by 4 publications

(2 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…5 A few TLA factors that have previously been investigated include influence of TLA fluid temperature, effect of bicarbonate buffering and effect of antegrade or retrograde TLA fluid delivery. [6][7][8] TLA has its origins in plastic surgery, in liposuction procedures, when large TLA fluid volume is injected to induce tumescence (tissue engorgement with fluid), as reported by Klein in 1985. 9 Endovenous experience with TLA dates back to the early 2000s, with the introduction of thermal ablation procedures into clinical practice.…”

Section: Introductionmentioning

confidence: 97%

See 1 more Smart Citation

A practical approach to tumescent local anaesthesia in ambulatory endovenous thermal ablation

Nyamekye

2018

Phlebology

View full text Add to dashboard Cite

Background Thermal ablation, usually performed with tumescent local anaesthesia (TLA), is the preferred method for varicose veins treatment. Tumescent local anaesthesia is always cited; however, little detail of the procedure is presented in publications. This retrospective audit of clinical tumescent local anaesthesia practice aims to provide detailed information on an important aspect of endovenous practice. Methods Patients who underwent three types of endothermal treatment (Venefit, Radiofrequency Induce Thermal Therapy and Endovenous Laser Ablation) to a single saphenous trunk using tumescent local anaesthesia were assessed. Differences in tumescent local anaesthesia volume per unit length of treated vein were assessed for the followings: type of saphenous trunk, length of vein treated, effect of additional phlebectomy and bilateral versus interval unilateral treatment for bilateral veins. Descriptive data are reported as mean and standard deviation, and groups were compared using the one-way ANOVA test. Results Between 2008 and 2014, single-saphenous-trunk ambulatory TLA thermal ablation was performed in 979 patients, mean age was 54 years. A total of 1229 limbs had truncal ablations and synchronous phlebectomy was performed in 470 limbs. No tumescent local anaesthesia-related complications occurred. There was no significant difference in standardised tumescent local anaesthesia volume per centimetre (ml) used for the three devices. Tumescent local anaesthesia volume per centimetre (ml) differed significantly between saphenous trunks. On average, a standard 10-12 ml/cm of tumescent local anaesthesia was used for saphenous trunks. Mean total tumescent local anaesthesia volume per patient, when treating the great saphenous vein alone, was 931 ml for bilateral and 425 ml for unilateral treatment. Conclusion This report of over 1000 endovenous procedures demonstrates safe performance of laser and radiofrequency treatments using tumescent local anaesthesia. Although no attempt was made to determine minimum volume requirements, a mean tumescent local anaesthesia volume of 10-12 ml/cm administered to the perivenous space provides adequate anaesthesia for truncal saphenous ablation.

show abstract

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

A practical approach to tumescent local anaesthesia in ambulatory endovenous thermal ablation

Nyamekye

2018

Phlebology

View full text Add to dashboard Cite

show abstract

Tumescent Local Anesthesia: A Systematic Review of Outcomes

Liu

Lyengar

Schmults

et al. 2020

Preprint

View full text Add to dashboard Cite

IMPORTANCE: Tumescent local anesthesia (TLA, whereby anesthesia is achieved by injection of a highly diluted solution of local anesthesia into skin and subcutaneous tissues) is a technique for delivering anesthesia for superficial surgical procedures. TLA obviates the need for general anesthesia or intravenous sedation in most cases. Pain control and TLA-related complications are key factors in determining the success of TLA. OBJECTIVE: To conduct a systematic review of the English medical literature data regarding pain control and TLA-related complications in TLA surgical cases to determine its efficacy and safety EVIDENCE REVIEW: The review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). Searches of both the MEDLINE and EMBASE databases were performed. Articles using 10-point quantitative scales were included in the pain analysis. Complications were tabulated from cohort studies, case series, and case reports. A total of 184 articles cotaining reports of 71,483 surgical procedures met inclusion criteria, including 43 with pain outcomes and 141 reporting complications. FINDINGS: Liposuction procedures were associated with relatively low degree of both intra-operative pain (10-point visual analog scale 1.1 +/- 2.1) and post-operative pain (0.53 +/- 0.44) and the fewest complications (1.2%). The highest intra-operative and post-operative pain was reported in facial/cleft-lip surgery (3.7 and 3.99, respectively), while mastectomy was associated with highest post-operative complication risk (20.8%). There were 8 reported cases of death unlikely related to TLA: pulmonary embolus (4 cases), complications related to concurrent general anesthesia (2 cases), hemorrhage, and visceral perforation. There were 5 reported cases of death related to TLA (lidocaine/bupivacaine toxicity in 4 cases and one case of fluid overload) during its development when optimal dose and volume parameters were being established. There have been no TLA-associated deaths reported in the 33,429 cases published since 2003. CONCLUSIONS AND RELEVANCE This systematic review demonstrates TLA to be a safe and effective anesthetic approach. Its low-cost and rapid patient recovery warrant further studies of cost-reduction and patient satisfaction. Expanded education of TLA techniques in surgical and anesthesia training programs may be considered to broaden patient access to this anesthetic modality for cutaneous and subcutaneous surgical procedures.

show abstract

Possibilities of endovenous laser obliteration of subcutaneous veins with tumescence by cold saline solution

2020

View full text Add to dashboard Cite

Is the temperature of tumescent anesthesia applied in the endovenous laser ablation important? Comparison of different temperatures for tumescent anesthesia applied during endovenous ablation of incompetent great saphenous vein with a 1470 nm diode laser

Abstract: We conclude that the temperature of tumescent anesthesia solution is not important, while the proper administration of tumescent solution in adequate amounts ensuring delivery of the fluid to all segments appears to be a more significant determinant for the success of the procedure.

Cited by 4 publications

References 22 publications

A practical approach to tumescent local anaesthesia in ambulatory endovenous thermal ablation

A practical approach to tumescent local anaesthesia in ambulatory endovenous thermal ablation

Tumescent Local Anesthesia: A Systematic Review of Outcomes

Possibilities of endovenous laser obliteration of subcutaneous veins with tumescence by cold saline solution

Contact Info

Product

Resources

About