A Clinical Comparative Study of Ultrasound-Guided Tumescent Local Anesthesia Versus Epidural Anesthesia in Great...

To compare the effects of ultrasound-guided tumescent local anesthesia (TLA) and epidural anesthesia in great saphenous vein stripping and to explore the feasibility of using TLA in this procedure.

This study included 144 patients diagnosed with varicose veins of the great saphenous vein who required surgical treatment and were admitted to the Second People's Hospital affiliated with Fujian University of Traditional Chinese Medicine from March 2020 to November 2023. Patients were divided into 2 groups based on the anesthesia method used, including the observation group (TLA) and the control group (epidural anesthesia), with 72 patients in each group. Both groups underwent high ligation, internal stripping, and microvenectomy of the great saphenous vein. Perioperative data were collected, and pain was assessed using the visual analog scale (VAS) immediately after anesthesia, immediately after surgery, 24 hours postsurgery, and 48 hours postsurgery. Intraoperative conditions, postoperative recovery, complications, and economic benefits were compared between the 2 groups.

Compared with the control group, the observation group had lower VAS scores immediately after anesthesia (3.6 ± 1.4 vs. 4.5 ± 1.7) and immediately after surgery (2.1 ± 1.4 vs. 3.3 ± 1.5) (P < 0.05). Blood pressure fluctuations (113.8 ± 9.8 vs. 120 ± 8.9 mm Hg) and heart rates (77.3 ± 7.8 vs. 97.3 ± 5.7 beats/min) during stripping were significantly lower in the control group (P < 0.05). The observation group had a significantly shorter postoperative bed rest duration (45.5 ± 11.9 vs. 93.6 ± 13.8 min), postoperative urinary retention (0 vs. 6 patients), postoperative deep vein thrombosis (1 vs. 7 patients), total postoperative hospital stay (1.7 ± 0.5 vs. 3.3 ± 0.5 days), and hospitalization costs (¥7,311.7 ± 117.5 vs. ¥9,234.3 ± 87.5) (P < 0.05). No significant differences were noted between the groups in terms of the VAS score at 24 and 48 hours postsurgery, operation time, postoperative nausea and vomiting, or incidence of postoperative incision infections (P > 0.05).

Ultrasound-guided TLA for great saphenous vein stripping reduces intraoperative pain, allows for earlier ambulation, and effectively minimizes postanaesthesia complications and deep vein thrombosis. This method enables quicker recovery and reduces hospitalization costs.