Difference between revisions of "Varicose vein stripping and ablation"
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Varicose vein stripping and ablation is a procedure involving removing | Varicose vein stripping and ablation is a procedure involving removing | ||
Endovenous thermal ablation have mostly replaced the surgical treatment of varicose veins | Endovenous thermal ablation (laser and light)have mostly replaced the surgical treatment of varicose veins<ref name=":0">{{Cite book|url=https://www.worldcat.org/oclc/1117874404|title=Anesthesiologist's manual of surgical procedures|date=2020|others=Richard A. Jaffe, Clifford A. Schmiesing, Brenda Golianu|isbn=978-1-4698-2916-6|edition=Sixth edition|location=Philadelphia|oclc=1117874404}}</ref> | ||
Usual indications include | Usual indications include failure of medical management with vein hemorrhage, superficial thrombophlebitis, or symptomatic veinous reflux <ref name=":1">{{Cite book|url=https://www.worldcat.org/oclc/1280374077|title=Stoelting's anesthesia and co-existing disease|date=2022|others=Roberta L. Hines, Stephanie B. Jones, Robert K. Stoelting|isbn=978-0-323-71861-5|edition=Eighth edition|location=Philadelphia, PA|oclc=1280374077}}</ref> | ||
Contraindication to surgery include pregnancy, and arterial insufficiency of the lower extremities | Contraindication to surgery include pregnancy, superficial or deep vein thrombosis, and arterial insufficiency of the lower extremities<ref name=":0" /><ref name=":1" /> | ||
== Preoperative management == | == Preoperative management == | ||
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! | ! | ||
!Variant 1 | !Variant 1 | ||
|- | |- | ||
|Position | |Position | ||
| | |Supine | ||
|- | |- | ||
|Surgical time | |Surgical time | ||
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|- | |- | ||
|Pain management | |Pain management | ||
| | |Minimal, multimodal | ||
|- | |- | ||
|Potential complications | |Potential complications | ||
| | |Bleeding and ulcers | ||
|} | |} | ||
Revision as of 19:24, 19 January 2022
Varicose vein stripping and ablation
Anesthesia type |
General vs regional vs local + MAC |
---|---|
Airway |
LMA |
Lines and access |
PIV |
Monitors |
Standard, 5 Lead EKG |
Primary anesthetic considerations | |
Preoperative | |
Intraoperative | |
Postoperative | |
Article quality | |
Editor rating | |
User likes | 0 |
Varicose vein stripping and ablation is a procedure involving removing
Endovenous thermal ablation (laser and light)have mostly replaced the surgical treatment of varicose veins[1]
Usual indications include failure of medical management with vein hemorrhage, superficial thrombophlebitis, or symptomatic veinous reflux [2]
Contraindication to surgery include pregnancy, superficial or deep vein thrombosis, and arterial insufficiency of the lower extremities[1][2]
Preoperative management
Patient preparation and premedication
- IV midazolam
- PO acetaminophen
Regional and neuraxial techniques
- Lower extremity regional techniques
- Spinal and or epidural
Intraoperative management
Monitoring and access
- Standard ASA monitors
- 5-lead EKG
- PIV x 1
Induction and airway management
- If general is chosen, standard induction
- LMA or Mask vs ETT
- Neuromuscular blockade may not be needed
- If regional/neuraxial is chosen, minimal to deep sedation is reasonable
- If local + MAC, deep sedation to general may be required [3]
- May require airway manipulation including oral airway or chin lift
Positioning
- Supine
Maintenance and surgical considerations
- Maintenance with volatile anesthetics or TIVA
- If regional/neuraxial is chosen, minimal to deep sedation is reasonable
Emergence
- PONV prophylaxis
Postoperative management
Disposition
- PACU
- Usually discharged home
Pain management
- Pain is minimal to mild
- Multimodal
- PO/IV acetaminophen
- PO/IV NSAIDS
- PO/IV short acting opioid
- Regional technique
- Multimodal
Potential complications
- Bleeding
- Ulcers
- Nerve injury
Procedure variants
Variant 1 | |
---|---|
Position | Supine |
Surgical time | 2-3 hours |
EBL | 50-250 mL |
Postoperative disposition | PACU, and usually discharged home |
Pain management | Minimal, multimodal |
Potential complications | Bleeding and ulcers |
References
- ↑ 1.0 1.1 Anesthesiologist's manual of surgical procedures. Richard A. Jaffe, Clifford A. Schmiesing, Brenda Golianu (Sixth edition ed.). Philadelphia. 2020. ISBN 978-1-4698-2916-6. OCLC 1117874404.
|edition=
has extra text (help)CS1 maint: others (link) - ↑ 2.0 2.1 Stoelting's anesthesia and co-existing disease. Roberta L. Hines, Stephanie B. Jones, Robert K. Stoelting (Eighth edition ed.). Philadelphia, PA. 2022. ISBN 978-0-323-71861-5. OCLC 1280374077.
|edition=
has extra text (help)CS1 maint: others (link) - ↑ Cho, Sooyoung; Han, Jong In; Baik, Hee Jung; Kim, Dong Yeon; Chun, Eun Hee (2016-04). "Monitored anesthesia care for great saphenous vein stripping surgery with target controlled infusion of propofol and remifentanil: a prospective study". Korean Journal of Anesthesiology. 69 (2): 155–160. doi:10.4097/kjae.2016.69.2.155. ISSN 2005-6419. PMC 4823411. PMID 27066207. Check date values in:
|date=
(help)
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