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tumescent anaesthesia

Tobias Hirsch
Treating varicose veins using endovenous thermal techniques - especially laser and radio frequency ablation - has emerged as an effective alternative to open surgery with stripping and high ligation. Even though these methods are very gentle and patient-friendly, they are nevertheless accompanied by risks and side effects. Compared to open surgical therapy, the risk of damage to peripheral and motor nerves is reduced; however, it still exists as a result of heat exposure and tumescent anaesthesia. Non-thermal methods that can be applied without tumescent anaesthesia have been introduced to the market...
December 16, 2016: VASA. Zeitschrift Für Gefässkrankheiten
Omar Rodriguez-Acevedo, Kristen E Elstner, Kui Martinic, Aaron Zea, Jenny Diaz, Rodrigo T Martins, Fernando Arduini, Alexandra Hodgkinson, Nabeel Ibrahim
BACKGROUND: Endovenous radio frequency ablation for small saphenous vein incompetence by and large appears to be superior and safer than conventional open surgery. Small saphenous vein ablation from approximately mid-calf to the point proximally where the small saphenous vein dives into the popliteal fossa is considered to be safe, as the sural nerve is in most cases separated from this segment of the small saphenous vein by the deep fascia. The outcome of the distal incompetent small saphenous vein remains unclear...
September 29, 2016: Phlebology
Clement C M Leung, Daniel Carradice, Tom Wallace, Ian C Chetter
BACKGROUND: Endovenous thermal techniques, such as endovenous laser ablation (EVLA), are the recommended treatment for truncal varicose veins. However, a disadvantage of thermal techniques is that it requires the administration of tumescent anaesthesia, which can be uncomfortable. Non-thermal, non-tumescent techniques, such as mechanochemical ablation (MOCA) have potential benefits. MOCA combines physical damage to endothelium using a rotating wire, with the infusion of a liquid sclerosant...
August 24, 2016: Trials
Dariush Nikkhah, Amir H Sadr, Mohammed Ali Akhavani
Technical steps to avoid incomplete proximal release of the carpal tunnel are described. Local anaesthesia is infiltrated as a subcutaneous bleb over the distal wrist crease and extending 2-3 cm over the forearm fascia. Tumescence of local anaesthesia into the subcutaneous plane helps create a pocket between the forearm fascia and subcutaneous tissues. Intraoperatively a subcutaneous pocket is made above the transverse carpal ligament and antebrachial fascia with blunt dissection. A retractor is placed under the pocket, which facilitates optimal visualization to allow reliable complete proximal release of compression...
June 2016: Journal of Hand Surgery Asian-Pacific Volume
Tom Wallace, Clement Leung, Sandip Nandhra, Nehemiah Samuel, Daniel Carradice, Ian Chetter
OBJECTIVES: To produce a tumescent anaesthesia solution with physiological pH for endovenous thermal ablation and evaluate its influence on peri- and postoperative pain, clinical and quality of life outcomes, and technical success. METHODS: Tumescent anaesthetic solution (0.1% lidocaine with 1:2,000,000 epinephrine) was titrated to physiological pH by buffering with 2 ml incremental aliquots of 8.4% sodium bicarbonate. Patients undergoing great saphenous vein endovenous laser ablation and ambulatory phlebectomy were studied before and after introduction of buffered tumescent anaesthetic...
June 15, 2016: Phlebology
Sunita Saha, Alok Tiwari, Charlotte Hunns, Jonathan Refson, Ahmed Abidia
OBJECTIVES: Tumescent local anaesthesia via multiple injections in the perivenous space leads to intraoperative and postoperative pain during endovenous laser ablation (EVLA). We considered whether the application of topical local anaesthesia reduces pain caused by these injections. METHODS: Eligible patients undergoing local anaesthetic EVLA were recruited and randomized to either application of topical local anaesthesia or water-based gel (placebo) to the inner thigh over the marked great saphenous vein...
August 2016: Therapeutic Advances in Cardiovascular Disease
Mark S Whiteley
In July 2013, the National Institute of Health and Clinical Excellence (NICE) recommended "endothermal" ablation (meaning endovenous thermal ablation) is the first line treatment for truncal venous reflux in varicose veins. The initial endovenous thermoablation devices were radiofrequency ablation and endovenous laser ablation. More recently, Glue (cyanoacrylate), endovenous steam and Clarivein (mechanochemical ablation or MOCA) have entered the market as new endovenous techniques for the treatment of varicose veins...
November 2015: Phlebology
Faraj O Alkizim, Daniel Kanyata, Joseph Githaiga, Joseph Oliech
A patient presents with penile ring incarceration after using it for penile enlargement and prolonging tumescence. We present a case study of removal of the penile ring under local anaesthesia in a setting where cutting tools were inadequate.
2015: International Journal of Surgery Case Reports
Thomas Oleg Meier, Vincenzo Jacomella, Robert Karl Josef Clemens, Beatrice Amann-Vesti
BACKGROUND: Tumescent anaesthesia (TA) is an important but sometimes very painful step during endovenous thermal ablation of incompetent veins. The aim of this study was to examine whether the use of fixed 50% nitrous oxide/oxygen mixture (N2O/O2), also called equimolar mixture of oxygen and nitrous oxide, reduces pain during the application of TA. PATIENTS AND METHODS: Patients undergoing endovenous laser ablation (EVLA) of incompetent saphenous veins were included...
November 2015: VASA. Zeitschrift Für Gefässkrankheiten
O V Bukina, V V Golovlev
UNLABELLED: The necessity of preventing venous thromboembolic complications in patients after endured surgical interventions for varicose disease remains a debatable problem. The study was aimed at assessing the incidence of deep vein thrombosis after phlebectomy and determining its clinical significance. MATERIAL AND METHODS: The authors carried out a prospective cohort study comprising a total of 86 patients (73 women and 13 men, aged from 16 to 64 years, the mean age 39...
2015: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
L Feldmeyer, I Bogdan, A Moser, R Specker, J Kamarashev, L E French, S Läuchli
BACKGROUND: Axillary hyperhidrosis is a common and distressing problem interfering with the life of affected individuals. Currently, local surgery is the treatment of choice once conservative treatment has failed. OBJECTIVES: To evaluate the clinical efficacy and safety of tumescent suction curettage (TSC) in treating axillary hyperhidrosis and to correlate it with histological markers. METHODS: Thirty patients (17 females and 13 males, average age 29...
October 2015: Journal of the European Academy of Dermatology and Venereology: JEADV
Sweta Rai, Alexander M Marsland, Vishal Madan
Autologous fat transfer (AFT) is an increasingly popular cosmetic procedure practiced by dermatologic surgeons worldwide. As this is an office based procedure performed under local or tumescent anaesthesia with fat transferred within the same individual and limited associated down time its is considered relatively safe and risk free in the cosmetic surgery arena. We describe a case of AFT related fat necrosis causing significant facial dysmorphia and psychosocial distress. We also discuss the benefits and risks of AFT highlighting common causes of fat graft failure...
July 2014: Journal of Cutaneous and Aesthetic Surgery
R Bootun, T R A Lane, B Dharmarajah, C S Lim, M Najem, S Renton, K Sritharan, A H Davies
OBJECTIVE: Endovenous techniques are, at present, the recommended choice for truncal vein treatment. However, the thermal techniques require tumescent anaesthesia, which can be uncomfortable during administration. Non-tumescent, non-thermal techniques would, therefore, have potential benefits. This randomised controlled trial is being carried out to compare the degree of pain that patients experience while receiving mechanochemical ablation or radiofrequency ablation. The early results of this randomised controlled trial are reported here...
February 2016: Phlebology
Arindam Sarkar, Jayanta Bain, Debtanu Bhattacharya, Raghavendra Sawarappa, Kinkar Munian, Gouranga Dutta, Ghulam Jeelani Naiyer, Shamshad Ahmad
INTRODUCTION: High-grade gynaecomastia (Simon IIb and III) has tissue excess (skin excess, enlarged areola, and displaced nipple), which is best managed surgically; however, results of conventional breast reduction surgeries and liposuction is not very good. Aim of our study was to describe a combined technique to manage these problems to produce a good result. MATERIAL AND METHOD: This was a 2-year study among 12 patients of high grade gynaecomastia. Clinical and laboratory findings were normal...
April 2014: Journal of Cutaneous and Aesthetic Surgery
S M McHugh, A L Leahy
BACKGROUND: Endothermal treatment of the great saphenous vein has become the first line of treatment for superficial venous reflux. Newer treatments, especially non-thermal ablation have potential benefits both for patient acceptability and decreased risk of nerve injury. APPROACH: We describe the current non-thermal options available including advantages and disadvantages. Ultrasound guided foam sclerotherapy avoids the risk of nerve injury, however it is not as effective as endothermal ablation...
October 2014: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
C Hamel-Desnos, P Desnos, F-A Allaert, P Kern
OBJECTIVES: To investigate the tolerance and safety of thermal ablation (TA), consisting of radiofrequency or endovenous laser (EVLA) of saphenous veins (SV) in elderly (group 1 ≥75 years), compared with a control group (group 2 <75 years). METHOD: An Observational multicenter-prospective study was conducted, under the aegis of the French and Swiss Societies of Phlebology (18 centers). Ninety patients were included in group 1, 617 in group 2 (mean age 80 years and 53 years; 69% women in both groups), representing 863 SV...
September 2015: Phlebology
S M Belentsov, B A Veselov, S A Chukin, M V Ektova, S E Makarov
OBJECTIVE: to investigate criteria for selection of patients for radiofrequency ablation (RFA), as well as to assess the immediate and remote outcomes of comprehensive minimally invasive treatment of patients presenting with class C2-C6 chronic venous disease (CVD). MATERIAL AND METHODS: we performed a total of 604 interventions in 512 patients (554 on the superior vena cava (diameter from 3 to 26 mm), 45 on the inferior vena cava (diameter from 3 to 14 mm), 5 on the anterior accessory veins (4-8 mm in diameter) The varicose veins were removed by means of compression sclerotherapy...
2013: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Yusuke Shimizu, Tomohisa Nagasao, Hiroko Taneda, Yoshiaki Sakamoto, Toru Asou, Nobuyuki Imanishi, Kazuo Kishi
Patients are occasionally unhappy with the size, shape, and positioning of breast implants. An option to improve their satisfaction with breast augmentation includes directly involving them in the process with awake surgery done under nerve block and tumescence. This study describes the resultsof using such an awake anaesthesia technique in 35 patients. After the intercostal nerves dominating the Th3 to Th6 regions were anaesthetized using 0.5% bupivacaine, a tumescent solution consisting of lidocaine, epinephrine, and saline was injected around the mammary gland, and breast augmentation was conducted using silicon implants...
February 2014: Journal of Plastic Surgery and Hand Surgery
Alexandra E Ostler, Judy M Holdstock, Charmaine C Harrison, Mark S Whiteley
Endovenous laser ablation is a minimally invasive catheter-based procedure for the treatment of varicose veins. The procedure involves injecting tumescent anaesthesia around the catheterised truncal vein, before thermal ablation by the laser. We report a case of a false aneurysm arising from a branch of the inferior epigastric artery, following endovenous laser ablation. The false aneurysm was thought to be caused by injury to the artery by the needle used to inject the tumescent anaesthesia. Although a rare complication, newer tumescentless techniques such as mechanicochemical ablation and cyanoacrylate glue would prevent such a complication...
April 2015: Phlebology
Kemal Korkmaz, Alı Ümit Yener, Hıkmet Selçuk Gedık, Alı Baran Budak, Özlem Yener, Serhat Bahadir Genç, Ayşe Lafçi
INTRODUCTION: Modern surgical management of chronic venous insufficiency is possible since the development of catheter-based minimally invasive techniques, including radiofrequency ablation (RFA) and the application of colour Doppler sonography. RFA technology requires the use of tumescent anaesthesia, which prolongs the operating time. Instilling tumescent anaesthesia percutaneously below the saphenous fascia is the steepest part of the learning curve. In our study, we compared operative and postoperative results of tumescentless RFA and RFA with tumescent anaesthesia, to investigate the necessity of tumescent anaesthesia...
September 2013: Cardiovascular Journal of Africa
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