Pain, Quality of Life, and Functional Capacity With Topical Sevoflurane Application for Chronic Venous Ulcers: A Retrospective Clinical Study

Abstract

IntroductionChronic venous ulcers (CVU) commonly have poorly controlled pain.ReportThirty patients older than 65 years of age with painful CVU were reviewed. At the initial visit, cleaning without sevoflurane was performed. Cleaning visits with sevoflurane every 2 days for 1 month were scheduled. The results of subsequent treatment with sevoflurane at the first, second, seventh, and twelfth cleanings were analysed. Pain was measured using a visual analog scale (VAS), quality of life by the Charing Cross Venous Leg Ulcer Questionnaire, and functional capacity by the Barthel Index.DiscussionInitial VAS was 8.8 ± 1.3 points and at the twelfth cleaning VAS was 0.8 ± 1 points (p = .001). Latency time ranged between 2 and 7 m and duration ranged between 8 and 18 h. It improved quality of life (83 ± 14 points before treatment vs. 50 ± 14 at the twelfth cleaning) and functional capacity (82 ± 13.3 before treatment vs. 91 ± 11.6 points at the twelfth cleaning) (p = .001). The safety profile was favourable with mild and self limited local cutaneous adverse effects, including pruritus, erythema, and heat. No systemic toxicity was detected. Topical sevoflurane may be a therapeutic alternative for painful CVU with a fast, intense, and long-lasting analgesic effect.

Quality of life related to clinical aspects in people with chronic wound

“…Thus, an evaluation of this index should serve as a subsidy for clinical practice in the most varied health care scenarios. This is what was observed in a study that evaluated QoL (19) in people with venous ulcer before and after topical sevoflurane application. The results demonstrated an improvement in QoL and functional capacity after the intervention, especially for providing quick and lasting reduction in pain.…”

Occurrence and Severity of Pain in Patients with Venous Leg Ulcers: A 12-Week Longitudinal Study

“…Although those issues were a subject of many previous studies, the vast majority of them were carried out at a single timepoint, had cross-sectional character and suffered from an array of confounders associated with differences in ulceration characteristics, treatments, and pain measurement methods. Based on published data, the prevalence of pain in patients with venous leg ulcers seems to vary considerably, from less than 30% to more than 90% [14,15], and even more significant discrepancies exist with regards of the pain severity [3,[15][16][17][18].…”

Pain reduction of topical sevoflurane vs intravenous opioids in pressure ulcers

“…Sevoflurane (C 4 H 3 F 7 O) is a highly fluorinated, ether‐derived molecule widely used as an inhaled anaesthetic in the induction and maintenance of general anaesthesia. In recent years, some evidence has emerged highlighting its central and peripheral analgesic effects, even after topical application, as well as its wound‐healing properties in skin ulcers . Furthermore, halogenated anaesthetics have shown potent bactericide activities in liquid state, seemingly via a direct toxic action over the cellular membranes …”