Холодный раствор альтернатива, когда у больного аллергия на лидокаин.

Когда у пациента аллергия на препарат, его нельзя использовать ни в каком виде.

Abstract
OBJECTIVES AND DESIGN:

A systematic review and meta-analysis was conducted to compare clinical outcomes between endovenous laser ablation (EVLA), radiofrequency ablation (RFA), ultrasound-guided foam sclerotherapy (UGFS) and surgery.
METHODS:

We searched MEDLINE and Scopus from 2000 to August 2011 to identify randomised controlled trials (RCTs) comparing EVLA, RFA, UGFS, and surgery or combinations of these for treatment of varicoses. Differences in clinical outcomes were expressed as pooled risk ratio and unstandardised mean difference for dichotomous and continuous outcomes, respectively. Methodological quality was assessed using Cochrane tools.
RESULTS:

Twenty-eight RCTs were included. The primary failure and clinical recurrences were not significantly different between EVLA and RFA versus surgery with the pooled RR of 1.5 (95%CI:0.7, 3.0) and 1.3 (95%CI:0.7, 2.4) respectively for primary failure, and, 0.6 (95%CI:0.3, 1.1) and 0.9 (95%CI:0.6, 1.4) respectively for clinical recurrences. The endovenous techniques had advantages over surgery in lowering wound infections (RR = 0.3 (95%CI:0.1, 0. for EVLA), haematoma (RR = 0.5 (95%CI:0.3, 0. and 0.4 (95%CI:0.1, 0. for EVLA and RFA), and return to normal activities or work (mean differences = -4.9 days (95%CI:-7.1,-2.7) for RFA).
CONCLUSIONS:

The primary failure and recurrence in EVLA and RFA were non-significantly different compared with surgery. However, they had lower haematoma, less wound infection, less pain and quicker return to normal activities.

Several publications support the hypothesis of ascending or multifocal development of varicose disease starting from the distal superficial venous network. The surgical approach focusing on the treatment of the varicose reservoir by phlebectomies and meanwhile conservation of a refluxing saphenous vein is enjoying renewed attention. Treating insufficient tributaries of the insufficient saphenous vein may lead to abolition of the saphenous reflux, so the saphenous vein could be saved. This concept challenges the current approach to treatment of venous insufficiency, which usually focuses on the treatment of saphenous insufficiency.

...если притоки убрать, рефлюкс исчезнет. Заманчиво, но верится с трудом...