Safety of Outpatient Vein Stripping under Local Anesthesia and Propofol Sedation

Abstract

We studied the outcome of vein stripping under local anesthesia and propofol in 1,705 patients with primary varicose veins of the lower extremities (2,341 limbs) on an outpatient basis. The patient population included 444 males and 1,261 females. Average of patient age was 57 years old, and 6% of the patients (n口101) were over 75 years old. The operative procedures consisted of great saphenous vein (GSV) stripping in 1,963 limbs and small saphenous vein (SSV) stripping in 570 limbs. Full-length stripping accounted for slightly less than 40% of the all cases. Combined GSV and SSV stripping operations were performed in 192 limbs. No anesthetic intoxication occurred in any patient, whereas ventricular extrasystole due to propofol was observed in 2 patients. The operative complications were postoperative hemorrhage requiring emergency surgery in 1 patient and intraoperative difficulty in hemostasis in 5 patients. Wound infections developed in 8 limbs (0.3%), but all of the infections subsided after treatment on an outpatient basis. Taken altogether, nerve injuries affected 97 limbs (4.9%) of GSV stripping and 14 limbs (2.5%) of SSV stripping. Even in cases of full-length stripping, nerve injuries occurred in 67 limbs (9.0%) and 10 limbs (4.5%), respectively. The sural nerve was excised erroneously in one case of SSV stripping, however. There were no other clinically significant complications (deep venous thrombosis, pulmonary embolism, etc.), and no postoperative delirium was induced in the elderly patients.