title: Less painful tumescent solution for patients undergoing endovenous laser ablation of the saphenous vein.
abstract: BACKGROUND
  This study aims to investigate the efficacy of lidocaine, prilocaine, and bupivacaine used in tumescent solution during endovenous laser treatment (EVLT) on intraoperative and postoperative pain.
  
  
  METHODS
  This prospective randomized study included 90 patients. The patients were divided into 3 groups including 30 patients in each group, according to the content of local anesthetics in tumescent solution. All patients received EVLT treatment with lidocaine in group 1, prilocaine in group 2, and bupivacaine in group 3. Visual analog scale was used for the evaluation of intraoperative and postoperative pain.
  
  
  RESULTS
  The mean intraoperative pain score was 2.27 ± 1.53 in group 1, 1.97 ± 1.54 in group 2, and 3.05 ± 0.73 in group 3. On the first day postoperatively, the mean pain score was 2.57 ± 1.7 in group 1, 3.27 ± 1.23 in group 2, and 1.13 ± 0.94 in group 3 (P = 0.0001). Intraoperative and postoperative mean pain scores during first day follow-up were significantly lower in group 3.
  
  
  CONCLUSIONS
  Tumescent anesthesia is the most critical component of EVLT to improve comfort by reducing the pain. Therefore, we conclude that bupivacaine is an optimal alternative to lidocaine and prilocaine in tumescent anesthesia and can be used safely.
authors.affiliation: Department of Cardiovascular Surgery, Pamukkale University School of medicine, Denizli, Turkey. Electronic address: tevfik04@yahoo.com.
authors.forename: Tevfik
authors.initials: T
authors.lastname: Gunes
authors.affiliation: Department of Cardiovascular Surgery, Mehmet Akif Ersoy Training and Research Hospital, Istanbul, Turkey.
authors.forename: Firat
authors.initials: F
authors.lastname: Altin
authors.affiliation: Department of Cardiovascular Surgery, Diyarbakır Training and Research Hospital, Diyarbakir, Turkey.
authors.forename: Baris
authors.initials: B
authors.lastname: Kutas
authors.affiliation: Department of Cardiovascular Surgery, Acıbadem Atakent Hospital, Istanbul, Turkey.
authors.forename: Selim
authors.initials: S
authors.lastname: Aydin
authors.affiliation: Department of Cardiovascular Surgery, Medikal Park Hospital, Bursa, Turkey.
authors.forename: Kamuran
authors.initials: K
authors.lastname: Erkoc
authors.affiliation: Department of Cardiovascular Surgery, İzmir Atatürk Training and Research Hospital, Izmir, Turkey.
authors.forename: Bortecin
authors.initials: B
authors.lastname: Eygi
authors.affiliation: Department of Cardiovascular Surgery, Pamukkale University School of medicine, Denizli, Turkey.
authors.forename: Ihsan
authors.initials: I
authors.lastname: Alur
authors.affiliation: Department of Cardiovascular Surgery, Diyarbakır Training and Research Hospital, Diyarbakir, Turkey.
authors.forename: Ferit
authors.initials: F
authors.lastname: Ozdemir
mesh_terms: D000328:Adult; D000368:Aged; D000779:Anesthetics, Local / Q000009:adverse effects / Q000627:therapeutic use*; D002045:Bupivacaine / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects*; D008012:Lidocaine / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D011318:Prilocaine / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D012501:Saphenous Vein / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey; D014648:Varicose Veins / Q000175:diagnosis / Q000601:surgery*; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D011318:Prilocaine; D008012:Lidocaine; D002045:Bupivacaine