755 Comparative Safety and Efficacy of Local vs General Anaesthesia in Patients Undergoing Radiofrequency Ablation of Truncal Varicose Vein with Multiple Avulsions

Aim Local anaesthesia (LA) and general anaesthesia (GA) are both commonly employed in patients undergoing Radiofrequency Ablation (RFA) treatment for varicose veins. There is a current gap in the literature comparing the two methods with respect to patient safety and operative time efficiency. Assessment is vital in optimising patient outcomes, accurate risk counselling and planning service provision. We aim to compare the safety and efficiency of LA versus GA in patients undergoing RFA with multiple avulsions (MA). Method Between July 2022 and October 2023, 85 patients (43 males, mean age 58 years) who underwent radiofrequency ablation of truncal veins with multiple avulsions under general anaesthesia or local anaesthesia were retrospectively analysed. Results Of the 85 patients, 39 were LA and 46 were GA. Combined anaesthetic and operative time was significantly shorter in the LA cohort. Local anaesthetic procedures were associated with shorter time from anaesthetic room to operation start time (11.97 +/- 10.2) 29.26 +/- 10.9 mins [p<0.001]) and shorter procedures (57.85 vs 70.67 mins [p<0.05]). There was no significance increase in postoperative venous thromboembolism and or emergency attendance within 30 days between the two groups. Findings were consistent when controlling for age, sex, ASA grade, anaesthetic type, and disease severity (as per CEAP scoring). Conclusions Performance of RFA with multiple avulsions in the treatment of varicose veins under local rather than general anaesthesia increases time efficiency of operative services without compromising on patient safety. Vascular surgeons should utilise local anaesthetic, where possible, to manage the long waiting lists patients with superficial venous incompetence.