Local Anaesthetic Flush Reduces Postoperative Pain and Haematoma Formation After Great Saphenous Vein Stripping--A Randomised Controlled Trial

Eur J Vasc Endovasc Surg. 2006 Mar;31(3):325-31. doi: 10.1016/j.ejvs.2005.08.006. Epub 2005 Oct 19.

Abstract

Objectives: To observe the effect of local anaesthetic flush through the great saphenous vein (GSV) tunnel on postoperative pain and haematoma formation following saphenous vein stripping operations.

Design: Prospective, double-blind, randomised, control trial.

Methods: One hundred patients were randomized to receive 20 ml of local anaesthetic (bupivacaine 0.25% + adrenaline) or saline control flush through the GSV tunnel after stripping in a double-blind study. Visual analogue pain scores were used to measure postoperative pain daily for the 1st week, then at 3 weeks and 6 weeks. Patients were examined during the 1st, 3rd and 6th week for haematoma formation.

Results: In the control group the median postoperative pain score was 4 (range 0-7) in the immediate postoperative period compared to a median of 1 (range 0-4) in the LA group (p<0.001). The median pain score on day-4 was 4 (range 1-6) (control) vs. 1 (range 0-3) (LA group) (p<0.001, Mann-Whitney Utest) and on day-6 it was 1 (range 0-5) (control) vs. 0 (range 0-5) (LA group) (p<0.001, Mann-Whitney). Twelve patients (24%) developed a haematoma in the GSV tunnel in the control group compared to three patients (6%) in the LA group (p = 0.007).

Conclusion: Flushing of the GSV tunnel with bupivacaine plus adrenaline significantly reduces postoperative pain and haematoma formation in patients undergoing GSV stripping for varicose veins.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anesthetics, Local / administration & dosage*
  • Area Under Curve
  • Bupivacaine / administration & dosage*
  • Double-Blind Method
  • Female
  • Hematoma / prevention & control*
  • Humans
  • Intraoperative Period*
  • Male
  • Middle Aged
  • Pain Measurement
  • Pain, Postoperative / prevention & control*
  • Prospective Studies
  • Saphenous Vein / surgery*
  • Time Factors
  • Varicose Veins / surgery*
  • Vascular Surgical Procedures*

Substances

  • Anesthetics, Local
  • Bupivacaine