• Tevfik Gunes, Firat Altin, Baris Kutas, Selim Aydin, Kamuran Erkoc, Bortecin Eygi, Ihsan Alur, and Ferit Ozdemir.
• Department of Cardiovascular Surgery, Pamukkale University School of medicine, Denizli, Turkey. Electronic address: tevfik04@yahoo.com.
• Ann Vasc Surg. 2015 Aug 1; 29 (6): 1123-7.

BackgroundThis study aims to investigate the efficacy of lidocaine, prilocaine, and bupivacaine used in tumescent solution during endovenous laser treatment (EVLT) on intraoperative and postoperative pain.MethodsThis prospective randomized study included 90 patients. The patients were divided into 3 groups including 30 patients in each group, according to the content of local anesthetics in tumescent solution. All patients received EVLT treatment with lidocaine in group 1, prilocaine in group 2, and bupivacaine in group 3. Visual analog scale was used for the evaluation of intraoperative and postoperative pain.ResultsThe mean intraoperative pain score was 2.27 ± 1.53 in group 1, 1.97 ± 1.54 in group 2, and 3.05 ± 0.73 in group 3. On the first day postoperatively, the mean pain score was 2.57 ± 1.7 in group 1, 3.27 ± 1.23 in group 2, and 1.13 ± 0.94 in group 3 (P = 0.0001). Intraoperative and postoperative mean pain scores during first day follow-up were significantly lower in group 3.ConclusionsTumescent anesthesia is the most critical component of EVLT to improve comfort by reducing the pain. Therefore, we conclude that bupivacaine is an optimal alternative to lidocaine and prilocaine in tumescent anesthesia and can be used safely.Copyright © 2015 Elsevier Inc. All rights reserved.

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