Regional Anesthesia and Recovery After Varicose Vein RFA

Zonguldak Bulent Ecevit University40 enrolled

Overview

This prospective observational study aims to compare the effects of spinal anesthesia and supra-inguinal fascia iliac block (SIFIB) on the quality of postoperative recovery in endovenous radiofrequency ablation (RFA) of varicose veins. The primary outcome measure of the study is the QoR-40 quality of recovery score. Secondary outcome measures include postoperative pain scores (VAS/NRS), motor block level (Bromage Scale), perfusion index (PI), time to first mobilization, and patient and surgeon satisfaction.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Suprainguinal Fascia Iliaca Block Varicose Veins Radiofrequency Ablation Regional Anaesthesia

Interventions

Following standard monitoring (ECG, non-invasive blood pressure, SpO2, perfusion index), the patient will be prepared in a sitting position. Under aseptic conditions, the L3-L4 or L4-L5 intervertebral space will be identified using a midline approach; a 25-gauge Quincke spinal needle will be inserted into the subarachnoid space. After confirmation of free CSF flow, hyperbaric bupivacaine 0.5% will be administered intrathecally.

SUPRAINGUINAL FACIA ILIACA BLOCKPROCEDURE

After standard monitoring (ECG, non-invasive blood pressure, SpO2, perfusion index), the patient will be placed in the supine position. Under aseptic conditions, a high-frequency linear ultrasound probe will be placed under the inguinal ligament to visualize the iliac fascia compartment; then, the probe will be slid cephalad over the inguinal ligament to identify the supra-inguinal approach point. Using the in-plane technique, a 22-gauge, 50 mm block needle will be passed through the iliac fascia under real-time ultrasound guidance. Negative aspiration will be confirmed by ultrasonographic visualization of the characteristic hydrodissection between the iliac fascia and the iliopsoas muscle. 40 mL of 0.20% bupivacaine local anesthetic will be injected.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age Profile: Adults aged between 18 and 65 years. * Physical Status: Patients classified as American Society of Anesthesiologists (ASA) Physical Status I, II, or III. * Informed Consent: Patients who voluntarily agreed to participate and provided written informed consent. * Cognitive Status: Patients who were conscious, oriented, and capable of cooperating with the pain assessment scales (NRS) and the QoR-40 questionnaire. Exclusion Criteria: * Venous Pathology: Presence of deep venous insufficiency (e.g., iliac or femoral vein obstruction, iliac vein stenosis) or acute deep vein thrombosis (DVT) in the lower extremity. * Systemic Diseases: Combined cardiac, pulmonary, hepatic, or renal dysfunction. * Hematological Disorders: Coagulation disorders or active bleeding diathesis. * Neurological/Cognitive Status: Presence of dementia, cognitive impairment, or inability to cooperate during the procedure. * Local Contraindications: Active infection at the site of the regional anesthesia intervention or surgical field. * Patient Refusal: Patients who declined regional anesthesia or had a known allergy to local anesthetics.

Outcomes

Primary Outcomes

Quality of Recovery-40 (QoR-40)

Patients were asked to complete the Quality of Recovery-40 (QoR-40) questionnaire preoperatively and at 24 hours postoperatively. The QoR-40 score ranges from 40 to 200, with higher scores indicating better quality of recovery.

Time frame: FIRST DAY AFTER SURGERY

Secondary Outcomes

Pleth Index

Time frame: The Pleth Index was measured preoperatively and every 10 minutes during the intraoperative period.

Pain Scores

Assessed using the Numerical Rating Scale (NRS)

Time frame: Measurements were taken at postoperative hours 0,2,4,6,12 and 24. The NRS score ranges from 0 to 10, with higher scores indicating more severe pain

Data from ClinicalTrials.gov

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