Comparative Study Between Ultrasound-Guided Femoro-sciatic Nerve Block Versus Unilateral Spinal Anesthesia in below Knee Orthopaedic Surgeries

Background: Lower limb varicose veins are seen in people with chronic venous insufficiency and lead to both discomfort and reduced quality of life. Aim of the work: To assess and evaluate the technical and follow-up outcomes of using radiofrequency ablation (RFA) in the treatment of primary lower limb varicose veins with respect to the venous access, comparing infragenicular and supramalleolar approaches. Emphasis is placed on the impact of these different access sites on clinical outcomes, postoperative complications, and recurrence rates.Patients and methods: A prospective randomized controlled trial was conducted at the Department of Vascular Surgery, Al-Azhar University Hospitals, and Tiba Hospital.30 patients with symptomatic primary varicose veins and duplex-confirmed reflux below the knee were randomized equally into two groups: Group A underwent infragenicular RFA, and Group B underwent supramalleolar RFA.Patients were followed for 6-month post-procedure, assessing procedural success, complications, and outcomes.Results: All participants showed full success in completing the first-day procedures.The success rate dropped to 93.3% in each group in week two, month one, and six months, with no significant change between the groups.Operating time in the infragenicular group was, on average, 20 seconds shorter than that in the supramalleolar group (p=0.019).Ecchymosis, skin burns, and paresthesia were equally common in both groups, but more people in the supramalleolar group had ecchymosis, and more people in the infragenicular group had skin burns.Conclusions: Infragenicular and supramalleolar methods of RFA are similarly effective and safe when used to treat primary lower limb varicose veins.