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.
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.
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.”
- 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.