title: Local anaesthetic flush reduces postoperative pain and haematoma formation after great saphenous vein stripping--a randomised controlled trial.
abstract: OBJECTIVE
  To observe the effect of local anaesthetic flush through the great saphenous vein (GSV) tunnel on postoperative pain and haematoma formation following saphenous vein stripping operations.
  
  
  METHODS
  Prospective, double-blind, randomised, control trial.
  
  
  METHODS
  One hundred patients were randomized to receive 20 ml of local anaesthetic (bupivacaine 0.25% + adrenaline) or saline control flush through the GSV tunnel after stripping in a double-blind study. Visual analogue pain scores were used to measure postoperative pain daily for the 1st week, then at 3 weeks and 6 weeks. Patients were examined during the 1st, 3rd and 6th week for haematoma formation.
  
  
  RESULTS
  In the control group the median postoperative pain score was 4 (range 0-7) in the immediate postoperative period compared to a median of 1 (range 0-4) in the LA group (p<0.001). The median pain score on day-4 was 4 (range 1-6) (control) vs. 1 (range 0-3) (LA group) (p<0.001, Mann-Whitney Utest) and on day-6 it was 1 (range 0-5) (control) vs. 0 (range 0-5) (LA group) (p<0.001, Mann-Whitney). Twelve patients (24%) developed a haematoma in the GSV tunnel in the control group compared to three patients (6%) in the LA group (p = 0.007).
  
  
  CONCLUSIONS
  Flushing of the GSV tunnel with bupivacaine plus adrenaline significantly reduces postoperative pain and haematoma formation in patients undergoing GSV stripping for varicose veins.
authors.affiliation: Department of Vascular Surgery, Mid-Western Regional and St John's Hospitals, Limerick, Ireland. aamnis@aol.com
authors.forename: A
authors.initials: A
authors.lastname: Nisar
authors.forename: J
authors.initials: J
authors.lastname: Shabbir
authors.forename: M A
authors.initials: MA
authors.lastname: Tubassam
authors.forename: A R
authors.initials: AR
authors.lastname: Shah
authors.forename: N
authors.initials: N
authors.lastname: Khawaja
authors.forename: E G
authors.initials: EG
authors.lastname: Kavanagh
authors.forename: P A
authors.initials: PA
authors.lastname: Grace
authors.forename: P E
authors.initials: PE
authors.lastname: Burke
mesh_terms: D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage*; D019540:Area Under Curve; D002045:Bupivacaine / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006406:Hematoma / Q000517:prevention & control*; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D012501:Saphenous Vein / Q000601:surgery*; D013997:Time Factors; D014648:Varicose Veins / Q000601:surgery*; D014656:Vascular Surgical Procedures
chemical_list: D000779:Anesthetics, Local; D002045:Bupivacaine