High ligation and stripping of the long saphenous vein using the tumescent technique for local anesthesia

BACKGROUND. Advantages of tumescent local anesthesia (TLA) have been described for use in ambulatory phlebectomy removing large varicose side branches. OBJECTIVE. TO evaluate the TLA method for high ligation and stripping of the long saphenous vein with or without administration of intravenous sedatives. METHODS. Forty-nine patients underwent 58 phlebosurgical procedures, including 41 ligations and strippings of the long saphenous vein. They were kept in the hospital for 24 hours after surgery to record potential complications and demand for medical assistance. RESULTS. The surgical procedures were easily performed under TLA without major complications. Minor complications were mild hematoma (n = 2) and temporary inguinal seroma (n = 1). Forty-one percent of the patients required additional IV sedation and analgesia perioperatively. Postsurgical guidance by a physician was necessary only in patients on fill-dose heparin. CONCLUSION. The tumescent technique for local anesthesia allows high ligation and stripping of the long saphenous vein even in both legs in one session, however, frequently with additional IV medication. (C) 1998 by the American Society for Dermatologic Surgery, Inc.