THE CHOICE OF THE MOST OPTIMAL METHOD OF ANESTHESIA FOR OPERATION ON THE LOWER EXTREMITY VESSELS

Abstract

Introduction. Varicose veins (VV) are characterized by saphenous, dilated, tortuous veins measuring three millimeters
or more, involving the saphenous veins, saphenous tributaries, or superficial veins of the legs. Manifestations of varicose
veins range from limited discomfort in the legs to swelling and non-healing ulcers, sometimes leading to disability. The
frequency and severity of these symptoms are directly related to age and gender. Due to the high variability of localization
and the degree of involvement of the venous network, there are various methods of surgical treatment of this pathology, as
well as a variety of methods of anesthesia with their inherent positive and negative qualities.
Aim. To analyse literature reflecting modern ideas about the prevalence of varicose veins of the lower extremities,
methods of surgical treatment and a reasonable choice of the safest and most effective method of anesthesia.
Search strategy. The search for publications was carried out in the following databases: PubMed, Embase, Scopus,
Web of Science, e-Library and Cyberleninka. Key queries included the following terms: chronic venous insufficiency, varicose
veins, phlebectomy, crossectomy, regional anesthesia, spinal anesthesia, epidural anesthesia, unilateral spinal anesthesia. The
search depth was 20 years, works from earlier years that were of high scientific value on this topic were also included.
Results and conclusions. The degree of quality of pain relief during VV surgeries, its duration, and comfort for the
patient and operating team are highly variable. The key factors are the number of complications associated with dural
puncture, patient satisfaction and time to recovery from anesthesia. The use of a choice of modern methods of anesthesia,
such as unilateral spinal anesthesia (USA), allows us to avoid most of the adverse effects of spinal anesthesia, while USA
supplemented with electrical nerve stimulation increases the safety of anesthesia, has high selectivity, and allows to
anesthetize only one lower limb of the patient.