Ambulatory Phlebectomy Using the Tumescent Anesthesia

Sim, Seung Joo; Lee, Chan Woo; Song, Ki Hoon; Hwang, Gi Baeg; Kim, Ki Ho

Abstract

BACKGROUND
Ambulatory phlebectomy is a cosmetically elegant outpatient procedure for the removal of varicose veins. One of the keys to its success is the ability to perform the procedure under local anesthesia. Tumescent anesthesia is applied in dermatologic surgery and now being expanded for use in phlebectomy. OBJECTIVE: To evaluate the efficacy and safety as well as advantages of 0.1% tumescent anesthesia with epinephrine in ambulatory phlebectomy. METHODS: Twenty-two patients(twenty-seven legs) without reflux at the SFJ were treated with ambulatory phlebectomy using the tumescent(0.1%) technique. In all patients, we monitored blood pressure, heart rate, and O2 saturation before, during, and after procedure. All patients were asked to rate the pain, both intraoperatively and postoperatively. They visited in hospital to record complications at one day, one week, and various monthly intervals (1, 3, 6, 12 months) following the initial treatment. RESULTS: The volume of anesthetic fluid ranged from 90 to 650ml, with an average of 320.7ml of fluid. Blood pressure, heart rate, and O2 saturation measured did not significantly change before, during, or after procedure. The average reported intraoperative pain for all interviewees was from 0 to 2. For postoperative pain, patients reported pain rate less than one. During operation, significant surgical blood loss is eliminated. There were minimal hematoma, purpura, and hyperpigmentation after operation. CONCLUSION: 0.1% Tumescent anesthesia provides a very safe, comfortable technique of anesthetizing patients for ambulatory phlebectomy and may decrease the incidence of complications.