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US-Guided Femoral and Sciatic Nerve Blocks for Analgesia During Endovenous Laser Ablation

  • Clinical Investigation
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CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

Endovenous laser ablation may be associated with significant pain when performed under standard local tumescent anesthesia. The purpose of this study was to investigate the efficacy of femoral and sciatic nerve blocks for analgesia during endovenous ablation in patients with lower extremity venous insufficiency.

Methods

During a 28-month period, ultrasound-guided femoral or sciatic nerve blocks were performed to provide analgesia during endovenous laser ablation in 506 legs and 307 patients. The femoral block (n = 402) was performed at the level of the inguinal ligament, and the sciatic block at the posterior midthigh (n = 124), by injecting a diluted lidocaine solution under ultrasound guidance. After the blocks, endovenous laser ablations and other treatments (phlebectomy or foam sclerotherapy) were performed in the standard fashion. After the procedures, a visual analogue pain scale (1–10) was used for pain assessment.

Results

After the blocks, pain scores were 0 or 1 (no pain) in 240 legs, 2 or 3 (uncomfortable) in 225 legs, and 4 or 5 (annoying) in 41 legs. Patients never experienced any pain higher than score 5. The statistical analysis revealed no significant difference between the pain scores of the right leg versus the left leg (p = 0.321) and between the pain scores after the femoral versus sciatic block (p = 0.7).

Conclusions

Ultrasound-guided femoral and sciatic nerve blocks may provide considerable reduction of pain during endovenous laser and other treatments, such as ambulatory phlebectomy and foam sclerotherapy. They may make these procedures more comfortable for the patient and easier for the operator.

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Acknowledgment

The authors thank Akdeniz University Scientific Research Projects Unit for supporting this study. None of the authors has a financial arrangement or other relationship that could be construed as a conflict of interest.

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Authors and Affiliations

  1. Department of Radiology, Akdeniz University School of Medicine, 07050, Arapsuyu, Antalya, Turkey

    Saim Yilmaz, Kagan Ceken, Emel Alimoglu & Timur Sindel

Authors
  1. Saim Yilmaz
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  2. Kagan Ceken
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  3. Emel Alimoglu
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  4. Timur Sindel
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Correspondence to Saim Yilmaz.

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Yilmaz, S., Ceken, K., Alimoglu, E. et al. US-Guided Femoral and Sciatic Nerve Blocks for Analgesia During Endovenous Laser Ablation. Cardiovasc Intervent Radiol 36, 150–157 (2013). https://doi.org/10.1007/s00270-012-0366-4

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  • DOI: https://doi.org/10.1007/s00270-012-0366-4

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