Combined popliteal and posterior cutaneous nerve of the thigh blocks for short saphenous vein stripping in outpatients: An alternative to spinal anesthesia

Study Objective: To compare a combination of peripheral nerve blocks with spinal anesthesia in ambulatory patients undergoing short saphenous vein stripping. Design: Prospective, randomized study. Setting: University hospital. Patients: 28 ASA physical status I and II ambulatory surgery patients undergoing short saphenous vein stripping. Interventions: 14 patients received a popliteal block (sciatic nerve block at the popliteal fossa) using 30 ml of alkalinized 3 % chloroprocaine and a posterior cutaneous nerve of the thigh block with 10 ml of 1 % lidocaine. The 14 patients who were randomized to the spinal anesthesia group received 65 mg of 5 % hyperbaric lidocaine. Measurements and Main Results: There were no significant differences in age and gender between the two groups (mean age 53 ± 13 years, 8 men and 20 women). Patients in the peripheral nerve block group recovered significantly faster in phase I of the postanesthesia care unit (PACU) (67 ± 10 min vs. 122 ± 50 min, p <0.01) and were discharged home sooner (222 ± 53 min vs. 294 ± 69 min, p <0.01) than the patients in the spinal anesthesia group. Conclusions: The combination of popliteal and posterior cutaneous nerve of the thigh blocks provided adequate anesthesia and a faster recovery profile with a similar subjective acceptance of both anesthetic techniques in ambulatory patients undergoing short saphenous vein stripping in the prone position.