Technique, Efficiency and Safety of Different Nerve Blocks for Analgesia in Laser Ablation and Sclerotherapy for Lower Limb Superficial Venous Insufficiency – A Multicentre Experience
Introduction: Laser ablation and sclerotherapy, as minimally invasive alternatives to surgery for varicose veins, have good efficacy, safety and cosmetic result. Some form of anaesthesia is generally used for pain control. Aim: To describe the technique and evaluate the efficacy and safety of f...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2016-11-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/8874/22897_CE[Ra1]_F(RK)_PF1(PI_RK)_PFA(AK)_PF2(PAG).pdf |
| Summary: | Introduction: Laser ablation and sclerotherapy, as minimally
invasive alternatives to surgery for varicose veins, have good
efficacy, safety and cosmetic result. Some form of anaesthesia
is generally used for pain control.
Aim: To describe the technique and evaluate the efficacy
and safety of femoral, saphenous and sciatic nerve blocks in
isolation or in combination for analgesia during laser ablation
and sclerotherapy for lower limb varicose veins.
Materials and Methods: In this prospective observational
study, over a period of 33 months, in 856 limbs of 681 patients
with varicose veins, ultrasound guided femoral, saphenous and
sciatic nerve blocks for analgesia were performed in 769, 808
and 52 instances respectively; following which, endovenous
laser ablation, sclerotherapy or combination of both were
carried out using standard practice. After completion of the
procedure, Visual Analogue Pain Scale (VAS) was used for pain
assessment, and muscle weakness was assessed clinically.
Results: Nerve blocks could be successfully performed in all
patients. Observed pain scores were 0 or 1 in 591 (69%), 2 or 3
in 214 (25%) and 4 in 51 (9%) legs with no score more than 4.
Higher grades of pain were noted in femoral blocks during early
stages of our learning curve. Mild to moderate muscle weakness
was observed in 163 (2%) and 7 (13%) patients who underwent
femoral and sciatic block respectively, which persisted for an
average of two and a half hours and none beyond four and a
half hours; saphenous nerve being a pure sensory nerve, did
not cause motor weakness.
Conclusion: For analgesia during laser ablation and/or
sclerotherapy of varicose veins, ultrasound guided nerve blocks
can be easily and quickly performed. They provide excellent
pain relief and comfort to the patient and to the operator; and
they do not cause any additional complication. |
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| ISSN: | 2249-782X 0973-709X |