title: Tumescent anaesthesia in combination with femoral nerve block for surgery of varicose veins: prilocaine 0.1% versus 0.2%.
abstract: OBJECTIVE
  Results of a prospective, randomized, double-blinded study about tumescent anaesthesia (TA) in combination with femoral nerve block (FNB) for surgery of varicose veins are reported. The aim is to compare two different concentrations of prilocaine in TA.
  
  
  METHODS
  With approval of the ethical committee and informed consent, FNB (nerve stimulation, 20 mL prilocaine 0.75%) was performed followed by TA using prilocaine 0.1% versus 0.2% (groups P0.1 and P0.2). Further medication was standardized. Overall amount of prilocaine was recorded, plasma levels of 20 patients measured regularly. Side-effects, patient satisfaction and pain scores were compared (P < 0.05).
  
  
  RESULTS
  Ninety patients were included. In one patient (P0.1), general anaesthesia was necessary. There was no difference in pain scores, need for rescue medication or patient satisfaction. More prilocaine was administered in P0.2 (P < 0.0001) with higher but far below toxic plasma levels. In three patients (P0.2) mild met-haemoglobinaemia was confirmed.
  
  
  CONCLUSIONS
  TA with prilocaine 0.1% in combination with FNB is sufficient to provide high patient satisfaction during varicosis surgery.
authors.affiliation: Department of Anaesthesia, Venenklinik, Kreuzlingen, Switzerland. hillerbrueggen@bluewin.ch
authors.forename: T
authors.initials: T
authors.lastname: Hillermann
authors.forename: A
authors.initials: A
authors.lastname: Dullenkopf
authors.forename: W
authors.initials: W
authors.lastname: Joechle
authors.forename: J
authors.initials: J
authors.lastname: Traber
mesh_terms: D000328:Adult; D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D004311:Double-Blind Method; D005260:Female; D005267:Femoral Nerve; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D011318:Prilocaine / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D011446:Prospective Studies; D014648:Varicose Veins / Q000601:surgery*
chemical_list: D000779:Anesthetics, Local; D011318:Prilocaine