Pain perception during and after VNUS ClosureFAST™ procedure

Abstract

The objective of the study was first to quantify the level of pain that patients experience during VNUS ClosureFAST™ and in the first week following treatment. Secondly, to investigate the use of pain medication. Thirdly, to identify after how many days patients return to daily activities and whether pain is a factor of influence. A prospective descriptive cohort study was carried out. In all, 104 consecutive VNUS ClosureFAST procedures for greater saphenous vein (GSV) incompetence between 18 May and 28 August 2009 in the HagaZiekenhuis were included. A visual analogue score (VAS) was recorded immediately after the procedure. These patients were asked to register pain scores during the week following the procedure, the amount of pain medication if used and the time elapsed between the procedures and resuming daily activities. The average VAS score during the VNUS Closure procedure was four. The first three days after the procedure the VAS score was 2. After four days, the average score was 1. The average return to daily activities was on day two after the procedure. In total, 24% of all patients used paracetamol after the procedure. In summary, VNUS ClosureFAST procedure for GSV incompetence is not a painless treatment. After an average of two days, patients return to their daily activities. Pain does not seem to be a major factor in the resumption. Seventy-six percent of patients do not use any pain medication.

Local anesthesia with lidocaine and prilocaine, using the tumescent technique, for the radiofrequency ablation of lower extremity varicose veins

“…reported an average pain score of 2.0, one day after a VNUS Closure FAST ™ ablation of the GSV without phlebectomy with the accompanying use of an average of 300 ml of tumescent solution. Furthermore, 24% of patients required a low dose of paracetamol for 1–3 days post‐intervention . Contrary to other reports, in which each patient was advised to take a nonsteroidal anti‐inflammatory drug for one week post‐endoluminal thermal treatment, we advised patients to take painkillers only when experiencing actual pain .…”

Less Painful Tumescent Solution for Patients Undergoing Endovenous Laser Ablation of the Saphenous Vein

“…In a study, Ross et al 18 used lidocaine for the local anesthesia. The authors reported that the mean pain score (VAS: 0-10) was 2 in the postoperative period.…”

Clinical utility of the Covidien Closure Fast™ Endovenous Radiofrequency Ablation Catheter

“…In a study of 104 patients, 45% returned to normal activity on the first postoperative day, with 100% at 1 week 20. Other studies have reported the number of days unable to work after the procedure to be 1 day, with a range of 0–28 days 17,18,21…”

“…In studies done under local anesthesia, Closure Fast™ produced average pain scores of between 3 and 4 out of 10 on a visual analog scale during the procedure (from the injection of tumescence). The average postoperative pain scores were less than 2 in the first week, with up to 76% of patients not requiring analgesia and those that did taking only paracetamol and simple non-steroidal anti-inflammatory drugs 18,20,21. The 46 patients in the RECOVERY study had pain scores of less than 1 at 48 hours reducing still further over the first week 22…”