Comparing anesthesia protocols in high intensity focused ultrasound treatments: The HIFU-pain study

Phlebology. 2025 Jun;40(5):358-364. doi: 10.1177/02683555241308044. Epub 2024 Dec 12.

Abstract

Backgroundto compare different anesthesia protocols during High Intensity Focused Ultrasound (HIFU) for saphenous trunk (GSV/SSV) and/or varicosities incompetence treatment.Material and methodspatients with GSV/SSV incompetence with varicose veins underwent HIFU under different anesthesia protocols. The primary endpoint was the pain score during HIFU using a 10-point scale.ResultsOut of 262 legs analyzed, main pain score was 1.03 ± 1.27. Intradermal + oral anesthesia treatments resulted in less procedural pain if compared with intradermal ± perivenous protocols (1.30 ± 0.19 vs 0.81 ± 0.09; p = .001). Conversely, perivenous injection decrease early complete recanalization rate.ConclusionThese preliminary results suggest that HIFU is an almost pain-free procedure. Procedural pain could be further minimized by using specific intradermal + oral anesthesia treatments, despite perivenous anesthetic could improve postoperative outcomes.

Keywords: High intensity focused ultrasound; anesthesia; chronic venous disease; varicose veins.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Anesthesia* / methods
  • Female
  • High-Intensity Focused Ultrasound Ablation* / adverse effects
  • High-Intensity Focused Ultrasound Ablation* / methods
  • Humans
  • Male
  • Middle Aged
  • Procedural Pain* / etiology
  • Procedural Pain* / prevention & control
  • Saphenous Vein* / surgery
  • Varicose Veins* / surgery
  • Varicose Veins* / therapy