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 re view 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, com fortable 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. (C) 1998 by the American Society for Dermatologic Surgery. Inc.