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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
A Journal on Vascular and Endovascular Surgery
Giornale Italiano di Chirurgia Vascolare 1998 March;5(1):43-9
language: English, Italian
Stripping of the great saphenous vein under local anesthesia using the “tumescent technique”. Technical notes
Ruju C., Montisci R., Brotzu G.
From the Department of Surgical Sciences and Organ Transplantation University of Cagliari, Cagliari, Italy
Background. The need to reduce costs and length of stay for surgery involving the superficial venous circulation, while maintaining high quality standards, prompted us to look into a special technique with the aim of combining the need for quality and anesthetic safety with early discharge.
Methods. A prospective study was made of 55 patients admitted to the surgery ward. All patients presented lower limb varicose veins requiring saphenectomy, but were otherwise in good health. Local anesthesia of the femoral nerve in Scarpa’s triangle was performed using 20 ml of a solution of lidocaine 500 mg, sodium bicarbonate 10 mEq and adrenaline 0.75 mg diluted in 1000 ml of a normal saline solution. Tissues around the saphenous vein, identified using an echo Doppler technique, were also infiltrated with 300-600 ml of the same solution, using a 30-cm blunt tip needle. Saphenectomy was then performed using Babcock’s technique.
Results. Analgesia was satisfactory in all cases and no side effects of the anesthetic solution were reported. Subcutaneous bruising was significantly reduced and patients were up 4 hours after surgery and discharged the following day.
Conclusions. We conclude that the technique described is easy to perform, provides optimal analgesia, has a low complications risk and helps to shorten the length of stay without decreasing the patient’s comfort and safety.