Comparison of the effectiveness of regional anesthesia under ultrasound guidance and tumescent anesthesia in the application of modern surgical treatment methods for chronic venous disease of the lower extremities.

Objective: Aim: To compare the effectiveness of tumescent anesthesia and regional anesthesia under ultrasound guidance in terms of their impact on nociceptive and stress systems, as well as systemic hemodynamics, in patients with chronic venous disease of the lower extremities, undergoing surgical treatment.

Patients And Methods: Materials and Methods: Fifty patients (average age 48 ±15 years; 19 [38 %] males and 31 [62 %] females) with chronic venous disease of the lower extremities, who underwent surgical treatment (endovenous laser ablation and miniphlebectomy on one limb), were examined. Twenty-five patients (main group) underwent surgery under femoral nerve block with 150 mg of lidocaine and sciatic nerve block (popliteal fossa) with 150 mg of lidocaine under ultrasound guidance. Another 25 patients (comparison group) underwent surgery under tumescent anesthesia, with the tumescent solution consisting of 400 mg of lidocaine, 50 mg of bupivacaine, and 400 ml of saline solution. We studied the parameters of systemic hemodynamics, heart rate variability, as well as blood glucose and plasma cortisol levels. The pain level was assessed by the use of the Visual Analogue Scale (VAS).

Results: Results: The VAS pain levels during regional anesthesia under ultrasound guidance for endovenous laser ablation and miniphlebectomy were significantly lower than in patients who received tumescent anesthesia.

Conclusion: Conclusions: The regional anesthesia method under ultrasound guidance in patients with chronic venous disease of the lower extremities more effectively reduces surgical stress compared to tumescent anesthesia.