274 - Double-blinded RCT Evaluating Regional Nerve Block for Pain Relief During Endovenous Laser Ablation of GSV: Does Addition of Obturator Nerve Block Make a Difference?

Purpose: To compare pain experienced during the Endovenous Laser Ablation procedure, for varicose veins, using a visual analogue scale (1-10) and post-procedure motor weakness in 3 groups of patients. Group 1(receiving obturator and femoral nerve block and tumescent anesthesia), Group 2 (patients receiving femoral nerve block and tumescent anesthesia), Group 3(no nerve block {sham mixture}and tumescent anesthesia).

Materials and Methods: Single-centre randomised, placebo-controlled, double-blinded study included 120 patients, randomized to three groups.

Patients aged between 18-75 years, with C (2-6), E(p), A(s), and P(r) according to the CEAP classification.

VAS during procedure, immediately after procedure, 1 hour after procedure was assessed.

Post-procedure motor weakness was assessed.

Results: Statistically significant difference in VAS pain scores between Group FNB +ONB + TA and Group without nerve block + TA and between Group FNB + TA and Group without nerve block + TA. VAS pain score on initial injections (distal medial thigh and proximal medial knee areas) showed a statistically significant difference between Group FNB + ONB + TA and Group FNB + TA.
There was a statistically significant difference in immediate post-procedure VAS pain scores between the 3 groups and 1-hour post-procedure between Group FNB + ONB + TA and Group without nerve block + TA.
Significant difference in motor weakness between Group FNB + TA and Group without nerve block + TA.

Conclusion: Pain score is significantly lower in patients undergoing EVLA under nerve block as compared to tumescent anesthesia alone. Addition of ONB in a specific set of patients significantly reduces pain scores, a new finding from our study which is not previously studied. Also, there was no significant difference in motor weakness between the groups in our study which is a significant new finding.