Stripping of the long saphenous vein under local anaesthesia - Own experience

Background: Vein diseases, particularly varicose veins have been recognized since antiquity. Despite the development of minimal invasive procedures, stripping of the long saphenous vein remains one of the most frequently performed procedures in varicose vein surgery. The aim of the study was the prospective evaluation of the results of the implementation of combined local anaesthesia in patients undergoing total or "limited" stripping. Material and methods: Surgical patients with sapheno-femoral junction incompetence (grade 2-4 according to Hach classification) were deemed to be qualified for this study. In all the cases, a blockade of the femoral nerve was performed followed by the administration of local anaesthetic solution injections in the places of varicose vein occurrence. From 2000 to 2004, 600 patients with varicose veins of the lower limbs were operated on. In this group, stripping (total or "limited") of the long saphenous vein was performed in 361 patients. In this paper, patient pain complaints were analysed (according to an analogue scale of 1-10). An assessment of the postoperative complication rate in this kind of anaesthesia as well as the severity of pain were evaluated (by means of an analogue scale of 1-10). Results: In this group, there were 2 patients reporting a median level of pain (6 points on an analogue scale of 1-10). In 10 further patients mild levels of pain were noticed (from 3 to 5 points). The remaining 349 patients reported very low levels of perioperative pain and there were no serious complications related to complaints of perioperative pain. In one case postoperative deep vein thrombosis was recognized. No cases of pulmonary embolia or surgical complications related to big vessel injury were recognized. Conclusions: Ambulatory stripping of the long saphenous vein under local anaesthesia is a safe and convenient method for patients undergoing varicose vein surgery. The administration of local anaesthesia allows one to avoid many procedure-related complications. Copyright © 2005 by Via Medica.