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Anesthesia

IV Sedation and Venous Insufficiency

01/20/2010

Question:

Hello, I am a 25 year old male, non smoker, physically fit/active, 5`10` 156 lbs. I am booked to have elective surgery to remove a mild case of gynecomastia (breast tissue) at a cosmetic surgery clinic in Brussels (I live in UK). The operation will last no more than an hour and I will be administered local anaesthesia with IV sedation. In addition to this embarrassing problem I`ve lately developed varicose veins on my legs. I’ve been diagnosed by doctors in the UK as having "Chronic venous insufficiency", more about this shortly. My question is; Will this venous insufficiency create a potential danger to my life/well being whilst under IV sedation? I am worried about this but don`t want to make an issue with the clinic (ie, tell them about venous insufficiency) as they might decide not to treat me if there is a small risk. Any input would be much appreciated, thanks!

Supporting information/symptoms: LEGS- varicose veins starting to form though not yet tortuous. Pain when standing and a feeling of pressure and discomfort when sitting. Drinking even medium levels of alcohol causes pins and needles type feeling in legs, this I fear might be a problem when I have sedatives coursing through my veins?

ARMS- pronounced/swollen arm veins, soreness in arms when arms are kept at my side for long periods, particularly in warm temperatures. Soreness is alleviated when I raise my arms higher than my heart.

In both legs and arms the symptoms have developed relatively quickly, really in the last 6 months. I`ve had smaller spider veins in my legs since I was 19 though.

I`ve had gynecomastia breast tissue since adolescence when I was overweight. I have since lost the weight but have never been able to loose the last little bit as there is breast tissue present which needs to be excised.

Answer:

Thanks for your question. Netwellness cannot provide medical advice to you. Three important points however:

1. It is most unwise to withhold details of your medical history from the medical team taking care of you. It may put your life at risk. Answer the questions they put to you honestly and forthrightly.

2. Chronic venous insufficiency is not usually a life-threatening condition and has no usual relevance to the risk of anesthesia, which is the only subject area on this forum that I am responsible for. Venous insufficiency is as far as I know usually limited to the lower limbs and symptoms in the arms could indicate another diagnosis.

3. Pins and needles might be attributable to venous insufficiency and varicose veins, but might on the other hand be due to a number of other causes including conditions affecting the central and peripheral nervous system.

In summary, you would be well advised to see your GP in the UK where you live for a medical checkup, and discuss in detail with him or her your plans for this surgery.

For more information:

Go to the Anesthesia health topic, where you can:

Response by:

Gareth S Kantor, MD Gareth S Kantor, MD
Assistant Professor of Anesthesiology
School of Medicine
Case Western Reserve University