Abstract
Background: Tumescent local anesthesia (TLA) has widespread applications in cosmetic surgery. We report over 80 cases of vascular surgery with TLA. Patients: Between September 2003 and March 2008, 82 patients underwent the vascular surgery with TLA. There were 37 men and 45 women aged from 40 to 89 years (mean 64.9 years). Because of several risk factors for general anesthesia or the wishes of the patient, we performed vascular surgery under TLA only or added TLA. Results: Operation was performed as these: Stripping for varicose veins 47, peripheral artery surgery 22, shunt implant 6, endovascular aortic repair 4, pacemaker implantation 2, remove and debridment of infected prosthesis for hemodialysis 1. Surgery underwent with TLA-only (n = 35), or added-TLA to the local/intravenous/spinal/epidural anesthesia (n = 47). There was no mortality, morbidity related to the surgery, surgical site infection or conversion to general anesthesia with intubation. Because 4 of the patients who underwent with TLA-only method could not remain immobile, they received intravenous anesthesia (n = 3) or isoflurane inhalation with a facemask (n = 1). Conclusion: Although the TLA technique may have possible application for peripheral arterial surgery on patients with risk factors for general anesthesia, indications of TLA-only procedures might be limited to procedures above inguinal lesion in peripheral artery operation.
