Femoral nerve block (FNB) guided by ultrasound represents a safe and effective strategy for reducing intraoperative pain associated with endoluminal laser ablation, according to a study published in Vascular Health and Risk Management.1

This small study assessed the safety and efficacy outcomes of using ultrasound-guided FNB without sedation for the reduction and/or elimination of discomfort associated with tumescent anesthesia injections during endovenous laser ablation for greater saphenous vein insufficiency. A total of 60 patients were assigned to receive tumescent anesthesia with (n=38), or without pre-procedural FNB under ultrasound guidance FNB (n=22). In order to assess patient discomfort levels during the procedure, a visual analog scale (0 to 10) was used at the start and the end of the ablation procedure.

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Greater pain scores were reported by patients who had not received the FNB vs patients who had (P <.001). The length of the greater saphenous vein and the duration of the procedure were similar in both groups. In addition, patients receiving FNB experienced no apparent complications.

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The investigator commented that this study is one of the few to evaluate the use of FNB followed by sedation or tumescent anesthesia.

In addition, the study investigator, Abdullah M Al Wahbi, MD, of the department of surgery, King Abdulaziz Medical City, Riyadh, Saudi Arabia, suggests that using ultrasound-guided FNB “will significantly reduce the pain and discomfort caused by tumescent anesthesia injections and allow early mobilization.”

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  1. Al Wahbi AM. Evaluation of pain during endovenous laser ablation of the great saphenous vein with ultrasound-guided femoral nerve block. Vasc Health Risk Manag. 2017;13:305-309.