Before we explain what tumescent anesthesia is, let’s talk about when it would be used in
vein care.
Endovenous
thermal ablation (using laser or radio frequency) is considered the gold
standard in treatment of the great and small saphenous veins, two veins that
are often the source of varicose veins in the lower leg.
Endovenous laser ablation (EVLA) uses
laser energy to create an intense localized thermal reaction in the incompetent
vein. The thermal energy causes vein to seal shut, stopping the healthy blood
flow from entering the damaged vein. This keeps the blood flowing toward the
heart, not allowing it to change directions and return to the feet. The body
will reabsorb the damaged and treated vein, forcing the blood to be diverted to
healthy veins in the leg.
EVLA is an
outpatient, minimally invasive procedure performed with local anesthetic.
Part of
the treatment involves tumescent
anesthesia, a technique in which a high volume of a dilute local anesthetic
is infiltrated around the vein. Tumescent anesthesia serves three purposes
during thermal ablation. First, the fluid causes the vein walls to collapse
around the thermal fiber maximizing contact. Second, the fluid creates an
insulating ring around the vein and thermal energy source. This protects all
surrounding tissues, including nerves and muscles, thus stopping any type of
collateral damage. The third function is as an anesthetic, keeping the patient
comfortable during the procedure.
The
introduction of tumescent anesthesia into the body should not be painful but
can be when administered by some physicians. Thus, before any vein treatment,
consult with a board certified phlebologist who can
provide a full understanding of all aspects of the procedure.
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