Varicose vein stripping and ablation
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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 have mostly replaced the surgical treatment of varicose veins
Usual indications include aching, swelling, heaviness, cramps, itching, cosmesis, stasis dermatitis, pigmentation, burning, and ulcers [1]
Contraindication to surgery include pregnancy, and arterial insufficiency of the lower extremities
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 [2]
- 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 | |
|---|---|
| Unique considerations | |
| Position | |
| Surgical time | 2-3 hours |
| EBL | 50-250 mL |
| Postoperative disposition | PACU, and usually discharged home |
| Pain management | |
| Potential complications |
References
- ↑ 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) - ↑ 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)
Top contributors: Cornel Chiu and Chris Rishel