Strategy to prevent nerve injury and deep vein thrombosis in radiofrequency segmental thermal ablation of the saphenous veins using a new objective pain scale. (September 2021)

• Record Type: Journal Article
• Authors: Yamamoto, Kenji; Miwa, Senri; Yamada, Tomoyuki; Setozaki, Shuji; Hamuro, Mamoru; Kurokawa, Shunji; Enomoto, Sakae
• Is Part Of: Phlebology. Volume 36:Number 8(2021)
• Page Start: 659
• Page End: 664
• Publication Date: 2021-09
• Subjects: Varicose veins -- endovenous ablation -- nerve injury -- deep vein thrombosis -- objective pain scale; Veins -- Diseases -- Periodicals; 616.14
• DOI: 10.1177/02683555211010513
• Languages: English
• ISSNs: 0268-3555

Abstract

Objective: We evaluated the benefit of local anesthesia including tumescent anesthesia and active walking soon after surgery in preventing nerve injury and deep vein thrombosis caused during endovenous ablation. Methods: Endovenous ablation was performed in 1334 consecutive patients. Varicectomy was performed using the stab avulsion technique. After surgery, patients were encouraged to walk 100–200 m inside the ward for 3–5 times/h. The pain was evaluated objectively using the Okamura pain scale and subjectively using the numerical rating scale. Results: Stab avulsion was performed at 11.8 ± 8.0 sites and the mean operative time was 33.9 ± 15.2 min. The mean Okamura pain scale and numerical rating scale scores were 1.6 ± 1.3 and 3.0 ± 2.0, respectively. Deep vein thrombosis and pulmonary embolism were absent. The incidence of nerve injury was 0.3%. Conclusions: Endovenous ablation should be performed with the patients under local anesthesia to prevent nerve injury and deep vein thrombosis.