Tumescent anaesthesia in combination with femoral nerve block for surgery of varicose veins: prilocaine 0.1% versus 0.2%

Abstract

Objective: Results of a prospective, randomized, double-blinded study about tumescent anaesthesia (TA) in combination with femoral nerve block (FNB) for surgery of varicose veins are reported. The aim is to compare two different concentrations of prilocaine in TA.

Method: With approval of the ethical committee and informed consent, FNB (nerve stimulation, 20 mL prilocaine 0.75%) was performed followed by TA using prilocaine 0.1% versus 0.2% (groups P0.1 and P0.2). Further medication was standardized. Overall amount of prilocaine was recorded, plasma levels of 20 patients measured regularly. Side-effects, patient satisfaction and pain scores were compared (P < 0.05).

Results: Ninety patients were included. In one patient (P0.1), general anaesthesia was necessary. There was no difference in pain scores, need for rescue medication or patient satisfaction. More prilocaine was administered in P0.2 (P < 0.0001) with higher but far below toxic plasma levels. In three patients (P0.2) mild met-haemoglobinaemia was confirmed.

Conclusion: TA with prilocaine 0.1% in combination with FNB is sufficient to provide high patient satisfaction during varicosis surgery.