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A Journal on Vascular and Endovascular Surgery

Official Journal of the Italian Society of Vascular and Endovascular Surgery
Indexed/Abstracted in: EMBASE, Scopus




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.

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