Tumescent Local Anesthesia with a Low Concentration of a Local Anesthetic for Varicose Vein Surgery: A Single Center Experience

Abstract

Recently, surgery for varicose veins generally requires a short stay, thus methods for anesthesia for the surgery should be selected appropriately. In our hospital, the standard treatment for incompetent great saphenous vein (GSV) is a high ligation of saphenofemoral junction with selective stripping of the GSV using an inversion technique. From April 2007, we change the method of the anesthesia, introducing tumescent local anesthesia (TLA) with a low concentration of a local anesthetic (containing diluted solution of 1% lidocaine^®). Here, we compared perioperative findings of patients undergoing the GSV surgery under the TLA, with those under conventional methods of anesthesia, i.e., an inhalation anesthesia with N₂O and sevoflurane and spinal anesthesia. The TLA was accompanied with continuous injection of propofol for sedation. In the postoperative periods, the TLA had the biggest effect as analgesic compared with the inhalation anesthesia and spinal anesthesia. However, presumably due to pharmacological characteristics of propofol, the TLA was less satisfied as an intraoperative anesthesia than the others. These results suggest that the TLA was useful for a day surgery of varicose veins and that, instead of propofol, combination of another sedation with the TLA, might be able to improve the intraoperative anesthetic effects.