title: US-guided femoral and sciatic nerve blocks for analgesia during endovenous laser ablation.
abstract: OBJECTIVE
  Endovenous laser ablation may be associated with significant pain when performed under standard local tumescent anesthesia. The purpose of this study was to investigate the efficacy of femoral and sciatic nerve blocks for analgesia during endovenous ablation in patients with lower extremity venous insufficiency.
  
  
  METHODS
  During a 28-month period, ultrasound-guided femoral or sciatic nerve blocks were performed to provide analgesia during endovenous laser ablation in 506 legs and 307 patients. The femoral block (n = 402) was performed at the level of the inguinal ligament, and the sciatic block at the posterior midthigh (n = 124), by injecting a diluted lidocaine solution under ultrasound guidance. After the blocks, endovenous laser ablations and other treatments (phlebectomy or foam sclerotherapy) were performed in the standard fashion. After the procedures, a visual analogue pain scale (1-10) was used for pain assessment.
  
  
  RESULTS
  After the blocks, pain scores were 0 or 1 (no pain) in 240 legs, 2 or 3 (uncomfortable) in 225 legs, and 4 or 5 (annoying) in 41 legs. Patients never experienced any pain higher than score 5. The statistical analysis revealed no significant difference between the pain scores of the right leg versus the left leg (p = 0.321) and between the pain scores after the femoral versus sciatic block (p = 0.7).
  
  
  CONCLUSIONS
  Ultrasound-guided femoral and sciatic nerve blocks may provide considerable reduction of pain during endovenous laser and other treatments, such as ambulatory phlebectomy and foam sclerotherapy. They may make these procedures more comfortable for the patient and easier for the operator.
authors.affiliation: Department of Radiology, Akdeniz University School of Medicine, 07050, Arapsuyu, Antalya, Turkey. ysaim@akdeniz.edu.tr
authors.forename: Saim
authors.initials: S
authors.lastname: Yilmaz
authors.forename: Kagan
authors.initials: K
authors.lastname: Ceken
authors.forename: Emel
authors.initials: E
authors.lastname: Alimoglu
authors.forename: Timur
authors.initials: T
authors.lastname: Sindel
mesh_terms: D000328:Adult; D000368:Aged; D000698:Analgesia / Q000379:methods; D015331:Cohort Studies; D057510:Endovascular Procedures / Q000009:adverse effects / Q000379:methods; D005260:Female; D005267:Femoral Nerve / Q000000981:diagnostic imaging / Q000187:drug effects; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects* / Q000379:methods; D008012:Lidocaine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D010147:Pain Measurement; D010690:Phlebography / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D012584:Sciatic Nerve / Q000000981:diagnostic imaging / Q000187:drug effects; D012720:Severity of Illness Index; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler / Q000379:methods; D014648:Varicose Veins / Q000000981:diagnostic imaging / Q000601:surgery*; D055815:Young Adult
chemical_list: D008012:Lidocaine