Local anesthesia with lidocaine and prilocaine, using the tumescent technique, for the radiofrequency ablation of lower extremity varicose veins.

AIM: To demonstrate the possible use of a tumescent solution containing lidocaine and prilocaine for radiofrequency-assisted segmental thermal ablation and to reduce the need for postoperative analgesics.

METHODS: Fifty patients (51 limbs) underwent radiofrequency-assisted segmental thermal ablation (VNUS Closure FAST(™) ) of insufficient great and small saphenous veins and phlebectomy. The amount of tumescent fluid injected was noted, and evaluation of pain reported on visual analog scale (VAS) and quantity of the postoperative analgesics used and their side effects were recorded one day and six weeks after the procedure.

RESULTS: The average amount of a tumescent fluid injected was 852 ml/patient (250-1470 ml). One day after surgery, 65% of the patients reported no pain (VAS 0), 27% reported a VAS of 1, and 4% reported a VAS of 2 on a scale of 0-10. Overall, 4% of the total patient population used analgesics after the procedure. Six weeks after the procedure, 84% of the patients reported no pain.

CONCLUSION: Local anesthesia with lidocaine and prilocaine, and the tumescent technique, were found to be effective and safe modalities for radiofrequency ablation of varicose veins of the lower extremities.