A recent double-blind, randomised clinical trial published in Annals of Surgery (2025) by Yuwei Xiang, Xinyan Wang, Jing Huang, Jing Xu, Li Wang, Zhoupeng Wu, Hankui Hu, Fei Xiong, Huanrui Hu and Yukui Ma evaluated whether adding dexamethasone to tumescent local anaesthesia (TLA) could reduce postoperative pain and improve recovery following radiofrequency ablation (RFA) for great saphenous vein (GSV) insufficiency.
In the study, 136 adult patients with GSV insufficiency (CEAP C2–C5) were randomly assigned: 67 received dexamethasone-enriched TLA and 69 received standard TLA before undergoing RFA. The primary outcome was pain on postoperative days 1 and 3, measured via Visual Analogue Scale (VAS). Secondary outcomes included quality of life (EQ-VAS, EQ-5D), Venous Clinical Severity Score (VCSS), local complications (e.g. ecchymosis), and GSV occlusion rates.
Results showed significantly lower median pain scores in the dexamethasone group on day 1 (1 vs. 2) and day 3 (0 vs. 1) compared to control (p = 0.010 and p = 0.007, respectively). Ecchymosis incidence was also lower (58.7% vs. 75.4%; p = 0.042). There were no statistically significant differences in VCSS, EQ-5D, thrombosis rates, or GSV occlusion between the two groups.
These findings suggest that dexamethasone-enriched TLA may offer a simple, cost-effective modification to standard RFA protocols—reducing early postoperative pain and bruising without compromising efficacy or safety. For practitioners, this could mean enhanced patient comfort, potentially faster recovery and improved satisfaction after GSV ablation.
At Phlebology News, we continue to track innovations that optimise both clinical outcomes and patient experience. This study’s results may influence how phlebologists approach periprocedural care in RFA — a modest but meaningful step toward improving the standard of varicose vein treatment.
