To compare the effect of cold or room temperature of tumescence anesthesia solution on pain perception during and after endovenous laser ablation (EVLA) for varicose veins of lower limb.
 Methods: A total of 51 patients with lower extremity varicose vein were treated by EVLA with tumescence anesthesia solution. All patients were used for local anesthesia and randomly divided into 2 groups according to the temperature of tumescence anesthesia solution: Group A (n=26) with room temperature (24 ℃) of tumescence anesthesia solution and Group B (n=25) with cold (4 ℃) tumescence anesthesia solution. Number rating scale (NRS) was recorded immediately after the procedure and postoperative 1, 2, 3 day. Patients were asked to register pain scores during the week.
 Results: The mean linear endovenous energy density (LEED) in the 2 groups was not significantly different (P>0.05). The ratio of patients without pain during the operation in the Group A was lower than that in the Group B (30.8% vs 64%, P<0.05). On the day of operation and postoperative day 1, 2, 3, the average number rating scale (NRS) scores in the Group A were greater than those in the Group B (P<0.05). Postoperative day 1, only 30.8% of the patients in the Group A resumed daily activities, which was lower than that (68% of the patients) in the Group B.
 Conclusion: In the process of EVLA for varicose veins of lower limb, there is less pain during operation and post-operation using cold tumescence anesthesia solution comparing room temperature tumescence anesthesia solution.
Anesthesia ; methods ; Cold Temperature ; Humans ; Intraoperative Complications ; physiopathology ; Laser Therapy ; Lower Extremity ; Pain Measurement ; Pain Perception ; physiology ; Pain, Postoperative ; physiopathology ; Treatment Outcome ; Varicose Veins ; physiopathology ; surgery

Venous hemodynamic changes after the surgery of primary varicose veins were evaluated. (Materials and methods) We retrospectively analyzed 1, 211 patients (1, 407 limbs) who underwent surgery for primary varicose veins from 1994 to 2002. The venous hemodynamics were evaluated using air- plethysmography (APG) preoperatively and one month postoperatively in the viewpoints of ambulatory venous pressure (AVP), venous volume (VV), venous filling index (VFI), and ejection fraction (EF). (Results) The surgical modalities included 958 cases of greater saphenous vein high ligation (GSV HL) and stripping with varicosectomy (VS), 222 cases of short saphenous vein (SSV) HL and VS, 143 cases of external banding valvuloplasty of GSV and VS, and 44 cases using VNUS (R) and VS. The reduction rate of VV was 20.9 +/- 14.1% in the GSV stripping group, 12.0 +/-14.7% in the GSV valvuloplasty group, 18.3 +/-16.1% in the VNUS (R) group, and 20.6 +/-15.9% in the SSV group. The reduction rate of VFI was 63.6 +/-20.7% in the GSV stripping group, 38.8 +/-40.9% in the GSV valvuloplasty group, 60.1 +/-23.9% in the VNUS (R) group, and 37.6 +/-30.2% in the SSV group. The increasing rate of EF was 25.0 +/-28.2% in the GSV stripping group, 21.0 +/-30.0% in the GSV valvuloplasty group, 29.4 +/-31.9% in the VNUS (R) group, and 30.0 +/-36.5% in the SSV group. The reduction rate of AVP was 25.4 +/-32.2% in the GSV stripping group, -6.1 +/-58.1% in the GSV valvuloplasty group, 28.4 +/-38.5% in the VNUS (R) group, and 14.1 +/-49.0% in the SSV group. All of the patients showed improvements in venous hemodynamics by showing a decrease in VV, VFI, AVP, and an increase in EF. However, there was no difference in the change of venous hemodynamics according to the type of surgery.
Adult ; Female ; Humans ; Leg/*blood supply ; Male ; Middle Aged ; Plethysmography ; Postoperative Complications ; Regional Blood Flow/*physiology ; Retrospective Studies ; Saphenous Vein/physiology/surgery ; Varicose Veins/*physiopathology/*surgery