Tumescent anesthesia in ambulatory phlebectomy.

BACKGROUND: Ambulatory phlebectomy is an elegant outpatient procedure for the removal of varicose veins. One of the keys to its success is the ability to perform the procedure under local anesthesia. A new form of anesthesia, tumescent anesthesia, has been developed for liposuction surgery and is now being expanded for use in other surgical disciplines.

OBJECTIVE: To determine the efficacy and safety as well as review the use and advantages of tumescent anesthesia in ambulatory phlebectomy.

METHODS: A retrospective review of phlebectomy cases performed in our offices under tumescent anesthesia.

RESULTS: The reported level of intraoperative and postoperative pain was very low. The complication rate was consistent with other reports except for a higher number of hematomas (3.4%).

CONCLUSIONS: Tumescent anesthesia provides a very safe, comfortable method of anesthetizing patients for ambulatory phlebectomy. Epinephrine, in appropriate concentrations, should be a part of all tumescent anesthetic solutions used for phlebectomy as it may decrease the incidence of hematoma.