title: Tumescent anesthesia in ambulatory phlebectomy.
abstract: BACKGROUND
  Ambulatory phlebectomy is an elegant outpatient procedure for the removal of varicose veins. One of the keys to its success is the ability to perform the procedure under local anesthesia. A new form of anesthesia, tumescent anesthesia, has been developed for liposuction surgery and is now being expanded for use in other surgical disciplines.
  
  
  OBJECTIVE
  To determine the efficacy and safety as well as review the use and advantages of tumescent anesthesia in ambulatory phlebectomy.
  
  
  METHODS
  A retrospective review of phlebectomy cases performed in our offices under tumescent anesthesia.
  
  
  RESULTS
  The reported level of intraoperative and postoperative pain was very low. The complication rate was consistent with other reports except for a higher number of hematomas (3.4%).
  
  
  CONCLUSIONS
  Tumescent anesthesia provides a very safe, comfortable method of anesthetizing patients for ambulatory phlebectomy. Epinephrine, in appropriate concentrations, should be a part of all tumescent anesthetic solutions used for phlebectomy as it may decrease the incidence of hematoma.
authors.affiliation: Department of Medicine, University of California, San Diego, USA.
authors.forename: S R
authors.initials: SR
authors.lastname: Smith
authors.forename: M P
authors.initials: MP
authors.lastname: Goldman
mesh_terms: D000556:Ambulatory Surgical Procedures; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D014648:Varicose Veins / Q000601:surgery*; D014680:Veins / Q000601:surgery*
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine