I need to undergo VNUS procedure on both saphenous veins and my doctor says that it can only be done under general anesthesia. I have read on this site and other that it is usually performed under local anesthesia. Which form of anesthesia is best, local or general?
All of the laser and RF procedures such as yours were developed to be done under local anesthetic in an office setting. Not only is this safe but it is also more cost effective for you. It is much more expensive for these to be done in a hospital/surgery center, plus the added risk of infection or complications due to anesthesia. The tumescent anesthetic we use is dilute, safe, and effective. You are in and out of the office within an hour, walking and getting on with your day.
Published on Jul 11, 2012
In my practice, the Venefit (formerly known as VNUS) closure procedure is performed in the office, in a relaxed setting, and without the need for general anesthesia. A patient may be offered a mild oral anti-anxiety agent one hour prior to the procedure. However, many patients do not want to take any medications and do very well with the procedure being performed with local anesthesia. They often walk in and out within an hour and are driven home by someone. They may drive and resume normal activities and exercises the next day.
Published on Jul 11, 2012
I have been performing the VNUS Closure procedure since 2001, and, for the past seven years have done the procedure exclusively in the office using local anesthesia (tumesent). There is absolutely no need for general anesthesia, intravenous sedation, or spinal. As a matter of comfort, I prescribe a low dose of Valium (2.5- 5.0 mg).
Published on Jul 11, 2012
It is totally unnecessary to do this procedure under general anesthetic. I
have done thousands of these procedures in an office setting using local
(tumescent) anesthetic without complications.
Published on Jul 11, 2012
This is a very important question and one you should take seriously.
I perform VNUS and endovenous laser for saphenous veins and would note recommend general anesthesia. In the reports of side effects/complications from VNUS under general anesthesia, the rate of deep vein thrombosis is much higher. This is likely due to limited mobility immediately following the procedure as you recover from the anesthesia.
There are many ways to treat varicose and spider veins, but the reality is that treatment is rarely performed at a hospital and general anesthesia is relatively contraindicated for thermal ablation alone. I would discuss this with your doctor and ask why the need for general anesthesia and what his/her experience has been with local tumescent anesthesia placed with ultrasound guidance. In my practice, tumescent anesthesia is all that is necessary to keep a patient pain free during the procedure.
In closing, I cannot possibly over emphasize the importance of walking following the procedure. General anesthesia will slow your recovery and ability to walk, raising your risk of deep vein thrombosis. I hope you have received this reply in time to consider the comments above.
Best wishes
Published on Jul 11, 2012
I have not used general anesthesia to perform VNUS or laser closure since I
first started in 2002. I have performed more the 7000 cases in the past 6
years and have never, I repeat NEVER, have not been able to successfully
perform the procedure under local anesthesia with only a small amount of
oral sedation (ativan 1-2 mg). Having the patient awake is safer, and also
allows the patient to tell me if they feel any "burning" in which case I can
stop immediately and place more liquid around the vein.
Published on Jul 11, 2012
Local anesthesia is the anesthesia of choice. Actually the anesthesia is called tumescent anesthesia.
Published on Jul 11, 2012
I would avoid general anesthesia for a radiofrequency or LASER ablation procedure. There is no need for the risk, cost, or inconvenience of general anesthesia.
Stephen F. Daugherty, MD, FACS, RVT, RPhS
Published on Jul 11, 2012