Phlebology
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Randomized Controlled Trial
Long saphenous tunnel infiltration with levobupivicaine reduces rescue analgesia requirements following varicose vein surgery: randomized, double-blind, placebo-controlled trial [ISRCTN58431114].
To determine whether local anaesthetic infiltration of the long saphenous tunnel in patients undergoing unilateral, primary long saphenous stripping and multiple avulsions reduces early postoperative pain and requirement for opiate analgesia. ⋯ In varicose vein surgery, local anaesthetic infiltration to the groin wound and along the full length of the stripper track is associated with reduced postoperative pain and requirements for opiate analgesia.
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The study was designed to analyse the risk indicators for a possible underlying malignancy and to evaluate whether extensive cancer screening is necessary in all patients with venous thromboembolism or not. ⋯ The risk of an underlying malignancy in patients with idiopathic venous thromboembolism is significantly higher. A moderate screening strategy has the capacity to identify the majority of the malignancies in such patients. We advocate simple laboratory tests, a chest X-ray and an abdominopelvic ultrasonography in order to search for an occult malignancy. A more extensive screening strategy may be considered for patients with suspicious findings for cancer, recurrent or bilateral venous thromboembolism and associated thrombosis in unusual sites.