title: Evaluation of ultrasound-guided femoral nerve block in endoluminal laser ablation of the greater saphenous vein.
abstract: BACKGROUND
  Endoluminal laser ablation has emerged as a new method for treating greater saphenous vein insufficiency. However, the procedure is not completely painless and requires applying tumescent anesthesia. The aim of this study was to evaluate the safety and efficacy of ultrasound-guided femoral nerve block in patients subjected to endoluminal laser ablation of the greater saphenous vein.
  
  
  METHODS
  Two consecutive groups of 25 patients subjected to ambulatory endoluminal laser ablation of the greater saphenous vein were analyzed in this study. Tumescent anesthesia only was applied in the first group. In the second group, before applying tumescent anesthesia, ultrasound-guided femoral nerve block was performed with 20 mL of 1% lidocaine. The pain during the application of tumescent anesthesia and vein ablation was evaluated by the patients using a 5-point scale. The heart rate and blood pressure was monitored during the procedures. The duration of the postprocedure stay in the recovery area was also recorded. The results were analyzed using statistical methods.
  
  
  RESULTS
  No complications associated with performing the femoral nerve block were observed. The pain associated with applying the tumescent anesthesia and that of performing the ablation was more intense in group 1 (p > 0.001). The volume of tumescent anesthesia solution was lower in group 2, 240 (±73) mL, compared to 399 (±137) mL in group 1, (p < 0.001). The group 2 patients had less hemodynamic changes during the procedure (p = 0.01).
  
  
  CONCLUSIONS
  In conclusion, ultrasound-guided femoral nerve block was shown to be a safe and effective option to decrease intraoperative discomforts associated with tumescent anesthesia and endoluminal laser ablation of the greater saphenous vein.
authors.affiliation: Vascular Department, Navarra University Clinic, Pamplona, Spain. ldzieciuchowicz@gmail.com
authors.forename: Lukasz
authors.initials: L
authors.lastname: Dzieciuchowicz
authors.forename: Gaudencio
authors.initials: G
authors.lastname: Espinosa
authors.forename: Lukasz
authors.initials: L
authors.lastname: Grochowicz
mesh_terms: D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures; D001794:Blood Pressure; D005260:Female; D005267:Femoral Nerve / Q000000981:diagnostic imaging*; D006339:Heart Rate; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D012501:Saphenous Vein / Q000601:surgery*; D013030:Spain; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D014689:Venous Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery*