Comparison of endovascular and stripping methods in combination with prolonged intravenous infusion therapy of lidocaine in treatment of chronic venous insufficiency

Abstract

The aim of the work: to compare the results of using endovascular and classical stripping methods in combination with intravenous administration of lidocaine solution for the treatment of chronic venous disease in the stage of trophic wounds. Materials and Мethods. The results of treatment of 78 patients with chronic venous insufficiency in stage C6 and C6r were evaluated. Subjects were divided into two clinical groups: group 1 – endovenous laser ablation (n=31) and group 2 (n=47) – classical surgical intervention (high ligation + great saphein vein stripping). In both groups method of prolonged intravenous lidocaine 2 % solution injection was used according to the proposed method. Postoperative monitoring was performed 1, 3, 6 months and 1 year after the surgical treatment. The result was evaluated when compared with the VCSS, VDS, VSDS scales. Results and Discussion. The dynamics of the pain syndrome when evaluated after 1, 3, 6 months generally showed its rapid regression among patients of both groups. In both experimental groups, the average value of the "number of active ulcers" before surgical treatment was (1.89 ± 0.06) points in the prospective group and (1.92 ± 0.08) points in the retrospective group, respectively, which indicated the presence of an average almost 2 active ulcers in one patient. After the treatment in group 1, rapid dynamics of healing of the wound surfaces was observed already after 1-3 months of postoperative treatment. While in group 2, after 6 months, somewhat slower dynamics were observed. In the same group, a year after treatment, the presence of recurrence of active trophic ulcers was noted in 10 % of patients.It was established that the combination of minimally invasive methods of treatment of varicose veins with endovenous laser coagulation in combination with prolonged administration of lidocaine solution significantly accelerates the healing of trophic wounds. At the same time, analyzing the indicators of the VCSS, VDS, VSDS scales, significantly better clinical indicators were established in terms of follow-up up to 1 year.