Is general anesthesia for endovenous ablation and microphlebectomy necessary?

I have a procedure coming up and I feel pressured from the doctors to get general anesthesia instead of local anesthesia. They tell me it's due to patient's comfort and that otherwise it will be painful, but I am decided on the local, how really painful it can be with anesthesia anyway?

Answers from doctors (6)


Vanish Vein and Laser Center

Published on Aug 29, 2019

I have not used general anesthesia for vein procedures for over 15 years. With the newer techniques of tumescent anesthesia, general anesthesia should rarely be necessary.

80% of my patients receive just tumescent anesthesia and about 20% receive tumescent and 1 mg orally of Ativan. They all tolerate the procedure very well.

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Answered by Vanish Vein and Laser Center

I have not used general anesthesia for vein procedures for over 15 years. With the newer techniques of tumescent anesthesia, general anesthesia should rarely be necessary.

80% of my patients receive just tumescent anesthesia and about 20% receive tumescent and 1 mg orally of Ativan. They all tolerate the procedure very well.

Published on Jul 11, 2012


Most often, these procedures are performed using local anesthetic. If you are uncomfortable with the recommendation of your physician, discuss your concerns. Based on they're response, you may seek a second opinion.

Answered by Advanced Vein & Laser Centre, Ltd. (View Profile)

Most often, these procedures are performed using local anesthetic. If you are uncomfortable with the recommendation of your physician, discuss your concerns. Based on they're response, you may seek a second opinion.

Published on Jul 11, 2012


Ross T. Lyon, MD, FACS

Published on Sep 11, 2017

It is not necessary to use general anesthesia during an EVLT/microphlebectomy procedure. A local anesthesia is safer and easily tolerated. There can be some discomfort during the procedure, so to mitigate this our patients take either 400-600mg ibuprofen/tylenol or 300-600mg hydrocodone taken 30 minutes prior to procedure, or nothing at all, depending on the patient's preference. These are simple procedures and do not require general anesthesia.

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Answered by Ross T. Lyon, MD, FACS

It is not necessary to use general anesthesia during an EVLT/microphlebectomy procedure. A local anesthesia is safer and easily tolerated. There can be some discomfort during the procedure, so to mitigate this our patients take either 400-600mg ibuprofen/tylenol or 300-600mg hydrocodone taken 30 minutes prior to procedure, or nothing at all, depending on the patient's preference. These are simple procedures and do not require general anesthesia.

Published on Jul 11, 2012


Vein Specialties of St. Louis

Published on Sep 11, 2017

EVLA and microphlebectomy using tumescent local anesthetic were developed to be able to have these procedures in an office setting. An experience vascular trained surgeon, using ultrasound guidance, is able to use local anesthetic for complete comfort during this. By having general anesthetic in a hospital/surgical center only increases risks to the patient not to mention greatly increasing the cost. I would recommend your seek a second opinion from a Board Certified Vascular trained surgeon who specializes in doing these procedures in an office setting. We have performed thousands of these procedures in our office, patients walk in and walk out in about an hour with complete comfort.

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Answered by Vein Specialties of St. Louis

EVLA and microphlebectomy using tumescent local anesthetic were developed to be able to have these procedures in an office setting. An experience vascular trained surgeon, using ultrasound guidance, is able to use local anesthetic for complete comfort during this. By having general anesthetic in a hospital/surgical center only increases risks to the patient not to mention greatly increasing the cost. I would recommend your seek a second opinion from a Board Certified Vascular trained surgeon who specializes in doing these procedures in an office setting. We have performed thousands of these procedures in our office, patients walk in and walk out in about an hour with complete comfort.

Published on Jul 11, 2012


More About Doctor Adey Agbetoyin, M.D.

Published on Sep 11, 2017

Both procedures are mostly done under local anesthesia.Your physician may recommend conscious sedation or, rarely, general anesthesia if you had a lot of pain and discomfort with a previous procedure. You should ask for option of microcosm sclerotherapy with Varithena, which can be done without general or even local tumescent anesthesia. This can take the place of microphlebectomy. There is also an option of mechanochemical ablation.
Lastly, general anesthesia usually means a separate additional bill from anesthesiologist. Discuss this with your physician also. Good luck.

Answered by Adey Agbetoyin, M.D. (View Profile)

Both procedures are mostly done under local anesthesia.Your physician may recommend conscious sedation or, rarely, general anesthesia if you had a lot of pain and discomfort with a previous procedure. You should ask for option of microcosm sclerotherapy with Varithena, which can be done without general or even local tumescent anesthesia. This can take the place of microphlebectomy. There is also an option of mechanochemical ablation.
Lastly, general anesthesia usually means a separate additional bill from anesthesiologist. Discuss this with your physician also. Good luck.

Published on Jul 11, 2012


Modern Vein & Laser Center

Published on Sep 11, 2017

These procedures can be done under local anesthesia only, painlessly. If a patient is nervous then sedatives may be added.

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Answered by Modern Vein & Laser Center

These procedures can be done under local anesthesia only, painlessly. If a patient is nervous then sedatives may be added.

Published on Jul 11, 2012


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