The Reasonability of Using Complex Medical Prescriptions for Tumescent Anesthesia When Performing Endovenous Laser Obliteration of Varicose Veins

INTRODUCTION. Despite the widespread use of methods for thermoobliteration of varicose veins, there are no standards for prescribing solutions for tumescent anesthesia when performing these operations. Existing prescriptions can be difficult, both in terms of finding the necessary components in a ce...

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Main Authors: B. V. Kozlovskij, V. A. Arustamyan, I. P. Mikhaylov, A. M. Demyanov
Format: Article
Language:Russian
Published: Sklifosovsky Research Institute for Emergency Medicine, Public Healthcare Institution of Moscow Healthcare Department 2024-09-01
Series:Неотложная медицинская помощь
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Online Access:https://www.jnmp.ru/jour/article/view/1884
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author B. V. Kozlovskij
V. A. Arustamyan
I. P. Mikhaylov
A. M. Demyanov
author_facet B. V. Kozlovskij
V. A. Arustamyan
I. P. Mikhaylov
A. M. Demyanov
author_sort B. V. Kozlovskij
collection DOAJ
description INTRODUCTION. Despite the widespread use of methods for thermoobliteration of varicose veins, there are no standards for prescribing solutions for tumescent anesthesia when performing these operations. Existing prescriptions can be difficult, both in terms of finding the necessary components in a certain concentration, and in terms of correct dilution of the components in saline.   AIM OF STUDY. To determine the reasonability of using complex medicinal prescription solutions for tumescent anesthesia when performing endovenous laser obliteration of varicose veins of the lower extremities.   MATERIAL AND METHODS. The prospective study included 64 patients who underwent endovenous laser obliteration of the great or small saphenous vein. The operations were performed in accordance with the standard protocol on a device with a wavelength of 1,940 nm and radiation power from 5.0 to 6.0 W. Tumescent anesthesia was created using an automatic infiltration pump using 21 G needles with a length of 120 mm. Group I included patients (n = 34) who were anesthetized with a 0.1 % lidocaine solution at room temperature. Group II included patients (n = 30), for whom the anesthesia solution was prepared according to Klein’s standard prescription for tumescent anesthesia. The distribution of patients into groups was carried out using random sampling. Evaluation criteria: the presence or absence of complaints of pain during surgery and the level of pain assessed using a visual analogue scale.   RESULTS. The groups did not differ statistically significantly in terms of main clinical and demographic indicators (p < 0.05). Complaints of pain or burning during surgery were made by 2 patients (5.9 %) in group I and 5 patients (16.7 %) in group II (p = 0.0023). The average pain value according to the visual analogue scale in group I was 0.75 cm [0.30; 1.44], in group II – 1.85 cm [0.85; 2.72], p = 0.0017, while in group I the maximum number of patients — 24 (70.6%) were distributed in the range of 0–1 cm, in group II the maximum number of patients, 17 (56.7 %) were distributed in the range of 1.5–3 cm according to a visual analogue scale.   CONCLUSIONS. When using a simple 0.1 % lidocaine solution for tumescent anesthesia, a significantly lower average pain value according to VAS was obtained in comparison with the group of patients who used the standard D. Klein solution (0.75 cm and 1.85 cm, respectively, p = 0. 0017). Also, for the study group, a significantly lower frequency of perioperative complaints and complaints of severe pain was obtained (p < 0.01). The use of complex prescriptions of solutions for tumescent anesthesia when performing endovenous laser obliteration of varicose veins is impractical. The use of a simple 0.1 % lidocaine solution at room temperature, while following the surgical protocol, provides comfortable anesthesia.
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spelling doaj-art-d2f41f975dcb44d39a1ef822fa7de1312025-08-20T03:56:36ZrusSklifosovsky Research Institute for Emergency Medicine, Public Healthcare Institution of Moscow Healthcare DepartmentНеотложная медицинская помощь2223-90222541-80172024-09-0113222623110.23934/2223-9022-2024-13-2-226-231939The Reasonability of Using Complex Medical Prescriptions for Tumescent Anesthesia When Performing Endovenous Laser Obliteration of Varicose VeinsB. V. Kozlovskij0V. A. Arustamyan1I. P. Mikhaylov2A. M. Demyanov3N.V. Sklifosovsky Research Institute for Emergency MedicineN.V. Sklifosovsky Research Institute for Emergency MedicineN.V. Sklifosovsky Research Institute for Emergency MedicineN.V. Sklifosovsky Research Institute for Emergency MedicineINTRODUCTION. Despite the widespread use of methods for thermoobliteration of varicose veins, there are no standards for prescribing solutions for tumescent anesthesia when performing these operations. Existing prescriptions can be difficult, both in terms of finding the necessary components in a certain concentration, and in terms of correct dilution of the components in saline.   AIM OF STUDY. To determine the reasonability of using complex medicinal prescription solutions for tumescent anesthesia when performing endovenous laser obliteration of varicose veins of the lower extremities.   MATERIAL AND METHODS. The prospective study included 64 patients who underwent endovenous laser obliteration of the great or small saphenous vein. The operations were performed in accordance with the standard protocol on a device with a wavelength of 1,940 nm and radiation power from 5.0 to 6.0 W. Tumescent anesthesia was created using an automatic infiltration pump using 21 G needles with a length of 120 mm. Group I included patients (n = 34) who were anesthetized with a 0.1 % lidocaine solution at room temperature. Group II included patients (n = 30), for whom the anesthesia solution was prepared according to Klein’s standard prescription for tumescent anesthesia. The distribution of patients into groups was carried out using random sampling. Evaluation criteria: the presence or absence of complaints of pain during surgery and the level of pain assessed using a visual analogue scale.   RESULTS. The groups did not differ statistically significantly in terms of main clinical and demographic indicators (p < 0.05). Complaints of pain or burning during surgery were made by 2 patients (5.9 %) in group I and 5 patients (16.7 %) in group II (p = 0.0023). The average pain value according to the visual analogue scale in group I was 0.75 cm [0.30; 1.44], in group II – 1.85 cm [0.85; 2.72], p = 0.0017, while in group I the maximum number of patients — 24 (70.6%) were distributed in the range of 0–1 cm, in group II the maximum number of patients, 17 (56.7 %) were distributed in the range of 1.5–3 cm according to a visual analogue scale.   CONCLUSIONS. When using a simple 0.1 % lidocaine solution for tumescent anesthesia, a significantly lower average pain value according to VAS was obtained in comparison with the group of patients who used the standard D. Klein solution (0.75 cm and 1.85 cm, respectively, p = 0. 0017). Also, for the study group, a significantly lower frequency of perioperative complaints and complaints of severe pain was obtained (p < 0.01). The use of complex prescriptions of solutions for tumescent anesthesia when performing endovenous laser obliteration of varicose veins is impractical. The use of a simple 0.1 % lidocaine solution at room temperature, while following the surgical protocol, provides comfortable anesthesia.https://www.jnmp.ru/jour/article/view/1884varicose veinsendovenous laser obliterationtumescent anesthesiapainvisual analogue scale
spellingShingle B. V. Kozlovskij
V. A. Arustamyan
I. P. Mikhaylov
A. M. Demyanov
The Reasonability of Using Complex Medical Prescriptions for Tumescent Anesthesia When Performing Endovenous Laser Obliteration of Varicose Veins
Неотложная медицинская помощь
varicose veins
endovenous laser obliteration
tumescent anesthesia
pain
visual analogue scale
title The Reasonability of Using Complex Medical Prescriptions for Tumescent Anesthesia When Performing Endovenous Laser Obliteration of Varicose Veins
title_full The Reasonability of Using Complex Medical Prescriptions for Tumescent Anesthesia When Performing Endovenous Laser Obliteration of Varicose Veins
title_fullStr The Reasonability of Using Complex Medical Prescriptions for Tumescent Anesthesia When Performing Endovenous Laser Obliteration of Varicose Veins
title_full_unstemmed The Reasonability of Using Complex Medical Prescriptions for Tumescent Anesthesia When Performing Endovenous Laser Obliteration of Varicose Veins
title_short The Reasonability of Using Complex Medical Prescriptions for Tumescent Anesthesia When Performing Endovenous Laser Obliteration of Varicose Veins
title_sort reasonability of using complex medical prescriptions for tumescent anesthesia when performing endovenous laser obliteration of varicose veins
topic varicose veins
endovenous laser obliteration
tumescent anesthesia
pain
visual analogue scale
url https://www.jnmp.ru/jour/article/view/1884
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