Intralesional Lidocaine Anesthesia: A Novel Facilitated Anesthesia Technique for Ethanol Sclerotherapy of Venous Malformation

Objective: The aim of this study was to describe a novel anesthesia, intralesional lidocaine anesthesia (ILA), for ethanol sclerotherapy of venous malformation and evaluate the efficacy and safety. Methods: A prospective study of 100 patients with venous malformations undergoing 100 sclerotherapy procedures with intralesional lidocaine anesthesia (ILA) was conducted. Pain was evaluated by numeric rating scale (NRS) immediately following the procedure. The grade of pain was classified by the NRS as no pain (0), mild (1–3), moderate (4–6), and severe (7–10). Local and systemic complications caused by lidocaine were recorded. Results: The median injected volume of absolute ethanol and 0.25% lidocaine was 5.9 mL and 17.0 mL, respectively. In ILA group, 13 patients had no pain during the procedure, 42 patients had mild pain, 38 patients had moderate pain, and 7 patients had severe pain. The mean NRS scores of the whole ILA group were 3.2 (0–8). No local or systemic complications attributed to lidocaine were reported. Conclusion: In a limited series, intralesional lidocaine anethesia seems to be efficient and safe for use in pain management for ethanol sclerotherapy of venous malformation. This anesthesia technique may be a promising first approach for the ethanol sclerotherapy of venous malformations, as it is easy to handle and has minimal sequelae.

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