The Efficacy of Femoral Block and Unilateral Spinal Anaesthesia on Analgesia, Haemodynamics and Mobilization in Patients undergoing Endovenous Ablation in the Lower Extremity

Öztürk, Tülün; Çevikkalp, Eralp; Nizamoglu, Funda; Özbakkaloğlu, Alper; Topçu, İsmet

doi:10.5152/tjar.2015.66933

Cited by 8 publications

(5 citation statements)

References 9 publications

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“…MAP was significantly higher in Group S as compared to group E, consistent with the results of other studies in this field ( 11 - 19 ). In the present study, unilateral spinal anesthesia was associated with greater intraoperative hemodynamic stability, which is in line with the results of other research ( 9 , 16 , 20 ). Nausea and vomiting are known consequences of spinal anesthesia.…”

Section: Discussionsupporting

confidence: 93%

Comparison of Hemodynamic Changes in Unilateral Spinal Anesthesia Versus Epidural Anesthesia Below the T10 Sensory Level in Unilateral Surgeries: a Double-Blind Randomized Clinical Trial

Kiasari¹,

Babaei²,

Alipour³

et al. 2017

Med Arch

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Background:Unilateral spinal anesthesia is used to limit the spread of block. The aim of the present study was to compare hemodynamic changes and complications in unilateral spinal anesthesia and epidural anesthesia below the T10 sensory level in unilateral surgeries.Materials and Methods:In this double-blind randomized clinical trial in total 120 patients were randomly divided into a unilateral spinal anesthesia group (Group S) and an epidural anesthesia group (Group E). Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and heart rates were measured before and immediately after the administration of spinal or epidural anesthesia and then at 5-, 10-, 15-, 20-, 25-, and 30-min intervals. The rates of prescribed ephedrine and intraoperative respiratory arrest were recorded, in addition to postoperative nausea and vomiting, puncture headaches, and back pain during the first 24 h after the surgery.Results:SBP, DBP, and MAP values initially showed a statistically significant downward trend in both groups (p = 0.001). The prevalence of hypotension in Group S was lower than in Group E, and the observed difference was statistically significant (p < 0.0001). The mean heart rate change in Group E was greater than in Group S, although the difference was not statistically significant (p = 0.68). The incidence of prescribed ephedrine in response to a critical hemodynamic situation was 5.1% (n = 3) and 75% (n = 42) in Group S and Group E, respectively (p = 0.0001). The incidence of headaches, back pain, and nausea/vomiting was 15.3%, 15.3%, and 10.2% in Group S and 1.8%, 30.4%, and 5.4% in Group E (p = 0.017, 0.07, and 0.49, respectively).Conclusion:Hemodynamic stability, reduced administration of ephedrine, a simple, low-cost technique, and adequate sensory and motor block are major advantages of unilateral spinal anesthesia.

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Section: Discussionsupporting

confidence: 93%

Comparison of Hemodynamic Changes in Unilateral Spinal Anesthesia Versus Epidural Anesthesia Below the T10 Sensory Level in Unilateral Surgeries: a Double-Blind Randomized Clinical Trial

Kiasari¹,

Babaei²,

Alipour³

et al. 2017

Med Arch

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“… 14 – 16 Furthermore, using regional nerve blocks such as spinal and sciatic blocks, in addition to the FNB, has the same risk of delayed mobilization and recovery. 8 – 11 …”

Section: Discussionmentioning

confidence: 99%

“…Multiple studies have shown the effectiveness of FNB; however, it has been used in combination with other nerve blocks or sedation that affect procedure time, postoperative mobility, and hospital stay. 8 – 11 Few studies have reported using FNB only, followed by TA or with sedation. 12 – 14 I report the effect of FNB and TA only for a completely painless EVLA procedure in an outpatient setting.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of pain during endovenous laser ablation of the great saphenous vein with ultrasound-guided femoral nerve block

Wahbi

2017

VHRM

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BackgroundEndoluminal laser ablation is now considered the method of choice for treating greater saphenous vein insufficiency. General anesthesia and peripheral nerve blocks with sedation have the risk of post-procedural delay in discharge and prolonged immobilization with the risk of deep vein thrombosis. The main pain experienced by patients during the procedure is during the laser ablation and the multiple needle punctures given along and around the great saphenous vein. The aim of our study was to evaluate the safety and efficacy of blocking the femoral nerve only under ultrasound-guidance without sedation, to reduce or prevent pain during injectable tumescent anesthesia in endovenous laser ablation of the greater saphenous vein.MethodsSixty patients in two groups underwent endovenous laser ablation for the greater saphenous vein insufficiency at an outpatient clinic. All patients received tumescent anesthesia. However, one group received a femoral nerve block (FNB) under ultrasound guidance before the procedure. All patients were asked to record the pain or discomfort, using the visual analog score, from the start of the procedure until the end of the great saphenous vein laser ablation. The length of the great saphenous vein and duration of the procedure were also recorded. The results were analyzed using statistical methods.ResultsNo complications from FNB were observed. The pain associated with application of tumescent anesthesia and laser ablation was more intense in the group without an FNB (P < 0.001). There was no significant difference between the two groups in the length of the great saphenous vein or procedure duration.ConclusionUltrasound-guided FNB (without other peripheral nerve blocks) is a safe, adequate, and effective option to decrease and/or eliminate the intraoperative discomfort associated with tumescent anesthesia injections and laser ablation during endoluminal laser ablation of the greater saphenous vein.

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“…Для обезболивания ЭВЛО, РЧА и мини-флебэктомии применяется тумесцентная анестезия, для стриппинга -проводниковая анестезия, хотя возможна и комбинация этих видов анестезии [1][2][3][4][5]. Проводниковая анестезия -это обратимая блокада передачи нервного импульса по крупному нервному стволу (нерв, сплетение, узел) путем введения раствора местного анестетика в параневральное пространство.…”

Section: амбулаторная анестезияunclassified

“…Следует помнить, что проводниковая анестезия вызывает не только сенсорный, но и моторный блок [3,5]. В рекомендуемой дозе (табл.…”

Section: рисунок 2 анатомическое расположение бедренного нерваunclassified

Anesthesia in outpatient phlebology practice

Bukina¹,

Sinitsyn²

2018

Stacionarozameshchayushchie tekhnologii: Ambulatornaya khirurgi

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Tumescent and/or conductive anaesthesia is the most frequently performed procedure to anesthetize the thermal types of surgical interventions, mini-phlebectomy and stripping of subcutaneous veins in outpatient settings. These interventions have become a common outpatient procedure almost everywhere, which made the issue of local anaesthesia more sensitive over the past 5 years in Russia. The aim is to compare the efficacy, safety and comfort when injecting various anaesthetic solutions to relieve pain during endovenous laser obliteration/radio frequency catheter ablation, stripping of the subcutaneous veins and mini-phlebectomy. Searching method. We searched for original articles in PubMed, in the archives of «Phlebology» and «Angiology and Vascular Surgery» journals issued for the period between 2001 and November 2018 and the search for official instructions in the state register of medicinal products. Selection criteria. We included all comparative studies: randomized and non-randomized, in which pain was assessed both during injection of a tumescent solution before EVLO and/or mini-phlebectomy and during surgery, as well as systematic reviews and monographs. Data analysis. In total, we identified 9 studies: 7 randomized and 2 non-randomized, one systematic review and two monographs. The advantage of a buffered solution over unbuffered one in terms of reducing pain during injection is revealed in three randomized, one simple comparative study and on the basis of systematic review data. A great efficacy of combining tumescent anaesthesia with a femoral nerve blockade, which was equivalent to spinal anaesthesia, was found in 4 randomized trials, two of which were double-blind, and one non-randomized. In addition, a smaller degree of motor block was reported after blocking the femoral nerve in comparison with spinal anaesthesia. In one randomized trial in which pain was assessed using cold and warm solutions, no significant differences in pain were observed either during or after surgery. In order to prepare a tumescent solution, lidocaine, prilocaine and mepivacaine were used at concentrations ranging from 0.028% to 0.2%; the advantages of higher concentrations over the lower ones have not been revealed. No adverse reactions and complications of anaesthesia have been reported in the studies, except for one where methaemoglobinemia of mild degree was detected in a small number of patients when using 0.2% prilocaine. The conclusion. Local anaesthesia, namely, conductive and tumescent anaesthesia, is an effective and safe anaesthesia method in outpatient surgery. Even very low concentrations of anaesthetic solutions are effective for tumescent anaesthesia. The use of buffered solutions increases significantly patient comfort during the injection. The combination of tumescent anaesthesia and femoral nerve block increases the effectiveness of anaesthesia. The femoral nerve block has significant advantages in comparison with spinal anaesthesia in terms of safety.

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The Efficacy of Femoral Block and Unilateral Spinal Anaesthesia on Analgesia, Haemodynamics and Mobilization in Patients undergoing Endovenous Ablation in the Lower Extremity

Cited by 8 publications

References 9 publications

Comparison of Hemodynamic Changes in Unilateral Spinal Anesthesia Versus Epidural Anesthesia Below the T10 Sensory Level in Unilateral Surgeries: a Double-Blind Randomized Clinical Trial

Comparison of Hemodynamic Changes in Unilateral Spinal Anesthesia Versus Epidural Anesthesia Below the T10 Sensory Level in Unilateral Surgeries: a Double-Blind Randomized Clinical Trial

Evaluation of pain during endovenous laser ablation of the great saphenous vein with ultrasound-guided femoral nerve block

Anesthesia in outpatient phlebology practice

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