Ambulatory phlebectomy under tumescent local anesthesia in a kidney-transplant patient.

INTRODUCTION Tumescent local anesthesia (TLA) is widely used for ambulatory surgery. Patients with transplanted or gans are on immunosuppressive therapy and with risk for organ rejection or severe infection. CASE REPORT Saphe nectomy with phlebectomy on the left leg under TLA was performed in a patient with kidney transplantation per formed four years ago. A combination of 35 mg of 1% prilocaine-hydrochloride, 5 mL of 8.4% sodium bicarbonate and 500 microg of epinephrine in 460 mL of normal saline was used for TLA. Overall 750 mL of the solution was used. The patient had satisfactory postoperative analgesia and was discharged home on the same day. Blood levels of urea, cre atinine, estimated glomerular filtration rate (eGFR) and ta crolimus concentration, measured preoperatively and on the second postoperative day, were in a regular range. Prilocaine blood concentrations determined on the 4th, 10th and 16th postoperative hours, were below toxic levels. CONCLUSION TLA in a kidney-transplanted patient performed for saphe nectomy with phlebectomy proved to be a safe and reliable anesthesia method.