Ultrasound-Guided Femoral Nerve Block for Pain Management in Endovenous Laser Ablation for Varicose Vein

Abstract

Background: Chronic venous insufficiency and its associated complications are a common condition affecting 15%–20% of the general population. Endovenous laser ablation (EVLA) is an effective day care treatment procedure. Tumescent anesthesia is given during EVLA to for pain relief and to prevent thermal damage to surrounding soft tissue by the laser energy. Regional nerve blocks can be given to reduce the pain of tumescent anesthesia and EVLA procedure. This study was aimed to evaluate pain score in varicose vein patients undergoing laser ablation with or without femoral nerve block. Materials and Methods: A total of 60 patients having only great saphenous vein disease were enrolled and divided into two Groups A and B using random number table. Group A was given tumescent anesthesia before laser EVLA procedure. Group B patients were given ultrasound guided femoral nerve block before tumescent anesthesia and laser ablation. Pain score was recorded intraoperatively, immediate and delated postoperative period (0, 1, and 3 h) on the Visual Analog Score. Data were analyzed using the standard statistical analysis tools. Results: Intraoperative and postoperative pain was significantly lower in Group B patients as compared to Group A (P < 0.0001). Volume of tumescent anesthesia used in Group B was significantly lower as compared to Group A. Conclusion: Femoral nerve block under ultrasound guidance is a safe, easy, and effective technique to reduce intra-operative and postoperative pain in patients undergoing EVLA without significant complications.