What is tumescent anesthesia?

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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