The Influence of Effective Analgesia and General Anaesthesia on Patients' Acceptance of Day Case Varicose Vein Surgery

1993 ◽  
Vol 8 (1) ◽  
pp. 29-31 ◽  
Author(s):  
O. C. Onuma ◽  
P. E. Bearn ◽  
U. Khan ◽  
P. Mallucci ◽  
M. Adiseshiah
Keyword(s):  
General Anaesthesia ◽  
Varicose Vein ◽  
Varicose Veins ◽  
Day Case ◽  
Varicose Vein Surgery ◽  
College Hospital ◽  
Day Case Surgery ◽  
Patient Interview ◽  
Case Surgery ◽  
Analgesia Requirement

Objective: To assess the efficacy of locoregional anaesthesia and non-opiate analgesia in controlling pain after varicose vein surgery. To examine patient attitudes to day case surgery for this condition. Design: Prospective single patient group study (22 consecutive patients). Setting: University College Hospital (Teaching Hospital). Intervention: Locoregional and general anaesthesia. Non-opiate analgesia. Surgical treatment for varicose Main outcome measures: Patient interview, pain scores, analgesia requirement. Result: Post operative Pain was absent in 36% during the first 24 hours. Oral analgesia was given to 36% as inpatients but only 18% after discharge. Before surgery, 95% would have preferred DCS but only 24% at six months. The after-effects of general anaesthesia was the main reason for this change in attitude. Conclusions: Patients would like day case surgery for varicose veins but anaesthesia and analgesia must be satisfactory.

Day-Case Surgery: A Viable Alternative for Surgical Treatment of Varicose Veins

1987 ◽  
Vol 2 (2) ◽  
pp. 103-108 ◽  
Author(s):  
D.C. Berridge ◽  
G.S. Makin
Keyword(s):  
Patient Group ◽  
Varicose Vein ◽  
Varicose Veins ◽  
Viable Alternative ◽  
Patient Treatment ◽  
Case Group ◽  
Day Case ◽  
Varicose Vein Surgery ◽  
Day Case Surgery ◽  
Case Surgery

One hundred and forty-eight patients (164 limbs) who had varicose vein surgery by the same consultant surgeon 3–10 years previously were reviewed; 61 patients had surgery as an in-patient and 87 as a day-case. The patients were reviewed to assess the efficacy and acceptability of day-case varicose vein surgery. There were no significant differences between the age and sex ratios of the patients. However, twice as many operations in the in-patient group included stripping of the long saphenous vein above the knee (χ2 = 4.2, P = 0.04). Fifteen in-patients had bilateral vein surgery as opposed to only one day-case patient. Fifteen patients suffered complications most of which were minor and were evenly distributed including wound infections (nine), reactionary haemorrhage/haematoma (four), deep vein thrombosis (one) and pulmonary embolus (one). The convalescent period before returning to work was similar in the two groups (U= 953, P= 0.28). The mean duration of stay for the in-patients was 3.9 ± 2.2 days. There was no significant difference in the period off work (day-case: 3.6 ± 2.0 weeks; in-patient: 4 ± 2.9 weeks), or in the length of follow-up (day-case: 6.01 ± 1.24 years; in-patient: 6.79 ± 1.71 years). In the period before review 11 patients in the in-patient group and 13 patients in the day-case group had further surgery or sclerotherapy for recurrent symptomatic varicose veins. At review five patients in the in-patient group and six patients in the day-case group had recurrent sapheno-femoral incompetence (χ2 = 0.1, P = 0.7). A total of 34 patients in both groups had recurrent varicose veins. Only four (4.6%) of the day-case patients expressed a preference for in-patient treatment if they were to have further surgery and 21 (34%) of the in-patient group would prefer day-case surgery. Day-case varicose vein surgery has not been shown to be inferior in terms of complications or recurrence rate. Patient acceptability is good and it is a viable alternative to in-patient treatment in suitable patients in areas with adequate district nurse facilities.

Advances in general surgery 50 years ago

2021 ◽  
pp. 1-2
Author(s):  
Harold Ellis
Keyword(s):  
General Surgery ◽  
Varicose Veins ◽  
Peptic Ulcers ◽  
Day Case ◽  
Day Case Surgery ◽  
Case Surgery ◽  
New Treatments

In 1971, some of the new advances that were set to change the field of general surgery included theories about the development of peptic ulcers, new treatments for varicose veins and pioneering work in the introduction of day case surgery.

Day Case Varicose Vein Surgery: Patient Health Outcome

2001 ◽  
Vol 16 (4) ◽  
pp. 160-163
Author(s):  
K. J. Sweeney ◽  
T. Cheema ◽  
S. O'Keefe ◽  
S. Johnston ◽  
P. Burke ◽  
...  
Keyword(s):  
Physical Function ◽  
Varicose Vein ◽  
Varicose Veins ◽  
Well Being ◽  
Health Perception ◽  
Day Case ◽  
Varicose Vein Surgery ◽  
Population Norms ◽  
Patient Health ◽  
The Impact

Background: The success of day case varicose vein surgery (DCWS) is traditionally denned clinically. However, the patient's perception of his or her own health prior to and following DCWS has not been established. This study prospectively measured the health status of patients with varicose veins, compared this with established population norms and assessed the impact of DCWS on both general health perception and varicose vein symptoms. Method: Fifty-three consecutive patients undergoing DCWS over a 9 month period were enrolled in this study. The SF-36 health assessment questionnaire and a vein-symptom-specific questionnaire were administered on the morning of surgery, 7 weeks postoperatively and 1 year following surgery. All patients in this study underwent a standard varicose vein operation and followed a standard protocol of postoperative management. Results: DCWS population health scores were lower than general population norms preoperatively. There was a significant improvement in the 7 week postoperative group in physical function and health perception (p<0.05). One year after surgery physical function, health perception, mental health and physical role were significantly improved from preoperative scores (p<0.05). Symptom-specific scores demonstrated a sustained trend towards improvement over the postoperative year. Conclusion: Varicose veins are associated with diminished well-being. Day case varicose vein surgery improves patient health perception and symptoms and is the treatment of choice for suitable patients with varicose veins.

The early morbidity of varicose vein surgery

1995 ◽  
Vol 81 (1) ◽  
pp. 42-46
Author(s):  
D C Mackay ◽  
D J Summerton ◽  
A J Walker
Keyword(s):  
Varicose Vein ◽  
Varicose Veins ◽  
Population Group ◽  
Postal Questionnaire ◽  
Varicose Vein Surgery ◽  
Long Saphenous Vein ◽  
Case Surgery ◽  
Post Operation ◽  
The Difference ◽  
Considerable Morbidity

AbstractThe early outcome and morbidity associated with varicose vein surgery were assessed at six months post operation by postal questionnaire. Most cases underwent sapheno-femoral ligation, above-knee stripping of the long saphenous vein and multiple stab avul sions. A 73.8% response rate resulted in 155 replies, and revealed a high incidence (65.8%) of perceived complications within the first two weeks after surgery. The commonest of these were bruising, pain and numbness. Over a third of patients consulted their general practitioner (GP) postoperatively. Half of these required further management or treatment and the rest, reassurance alone. At six months 79.4 % were satisfied with the outcome of their surgery, although some still claimed problems with residual veins, skin discoloration, numbness, and ankle or foot disco loration. Eleven percent were referred to hospital for further opinion, mostly because of perceived residual varicose veins. The difference between residual and recurrent varicose veins is discussed. No patient fe lt that the standard 2.5 day admission was too long, and 12.9% thought it too short. Day case surgery is not a popular option in this population group.Despite high satisfaction rates, there is a considerable morbidity attached to varicose vein surgery. We believe that good pre- and perioperative communication, augmented by a comprehensive information sheet, is important to prepare patients for those postoperative problems and thus reduces their perceived importance.

The Cost of Day-Case Surgery for Varicose Veins

1991 ◽  
Vol 6 (4) ◽  
pp. 223-225 ◽  
Author(s):  
A. Price ◽  
G. S. Makin
Keyword(s):  
Varicose Veins ◽  
University Hospital ◽  
Day Case ◽  
Day Case Surgery ◽  
Case Surgery ◽  
The Cost

A methodology is described to calculate the cost of day-case surgery at University Hospital, Nottingham during 1988/89, which may be suitable for use elsewhere. Day-case surgery for varicose veins is cheaper than the corresponding inpatient surgery.

scholarly journals Cognitive failures after general anaesthesia for day-case surgery

1996 ◽  
Vol 76 (2) ◽  
pp. 194-197 ◽  
Author(s):  
Y Tzabar ◽  
A J Asbury ◽  
K Millar
Keyword(s):  
General Anaesthesia ◽  
Day Case ◽  
Day Case Surgery ◽  
Cognitive Failures ◽  
Case Surgery
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