polidocanol and Pain--Postoperative

Minimally invasive approaches such as sclerotherapy have been introduced to treat aneurysmal bone cysts. Sclerotherapy has been associated with reasonable healing rates during the past two decades. However, it is unclear whether sclerotherapy compares with the more traditional extended curettage and bone grafting.. We therefore compared the healing rates and functional scores in patients having percutaneous repetitive sclerotherapy using polidocanol (Group 1) with those with intralesional excision (extended curettage with a high-speed burr) and bone grafting (Group 2) for treatment of aneurysmal bone cyst.. We randomly divided 94 patients into two treatment groups. We assessed healing rates (primary outcome measure), pain relief, time to healing and recurrence, hospital stay, and the Enneking functional score. Forty-five patients from Group 1 and 46 from Group 2 were available for study. The minimum followup was 3.2 years (mean, 4.4 years; range, 3.2-6.1 years).. At last followup, 93.3% in Group 1 and 84.8% in Group 2 had achieved healing. Complications in Group 1 were minor and resolved. In Group 2, three patients had deep infections and five had superficial infections, and two had growth disturbances. Although the healing rates were similar, we found higher rates of clinically important complications, worse functional outcomes, and higher hospital burden associated with intralesional excision.. Repetitive sclerotherapy using polidocanol is a minimally invasive, safer method of treatment for aneurysmal bone cysts compared with intralesional excision and bone grafting. In this preliminary study, we found similar recurrence rates for the two treatment methods, however, this will require confirmation in larger studies.. Level II, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Topics: Adolescent; Adult; Bone Cysts, Aneurysmal; Bone Transplantation; Child; Curettage; Female; Humans; Length of Stay; Logistic Models; Male; Pain Measurement; Pain, Postoperative; Polidocanol; Polyethylene Glycols; Radiography; Recovery of Function; Recurrence; Risk Assessment; Risk Factors; Sclerosing Solutions; Sclerotherapy; Time Factors; Treatment Outcome; Wound Healing; Young Adult

We have reviewed our experience (15 patients during the period 2008-2012) in the treatment of low flow vascular malformations (LFVMs) of the face and oral cavity with polidocanol foam sclerotherapy. They were diagnosed clinically and with the help of Doppler ultrasound and magnetic resonance imaging. The maximum dose recommended for each session was 20mg/day and the minimum interval between sessions was 4 weeks. Embolisation was repeated as many times as needed until the size of the lesions and the symptoms had been reduced sufficiently. Patients were followed up 1, 6, and 12 months after treatment had finished, and the size of the lesions was assessed objectively. The 8 men and 7 women were aged between 18 and 71 (mean 44) years. The lesions had reduced and symptoms had improved in all cases. During the follow-up period, one patient relapsed and developed further symptoms. The pain and postoperative inflammation were successfully controlled with an analgesic and an anti-inflammatory drug. There was only one complication (superficial necrosis), which healed completely by second intention. Direct puncture and sclerosis with polidocanol foam are an effective treatment for LFVM of the face and oral cavity.

Topics: Adolescent; Adult; Aged; Analgesics; Anti-Inflammatory Agents; Embolization, Therapeutic; Face; Female; Follow-Up Studies; Humans; Male; Middle Aged; Mouth Diseases; Pain, Postoperative; Polidocanol; Polyethylene Glycols; Punctures; Recurrence; Retrospective Studies; Sclerosing Solutions; Sclerotherapy; Tissue Adhesives; Treatment Outcome; Vascular Malformations; Young Adult

Thermal ablative techniques of varicose veins carry a risk of heat-related complications, including postoperative pain. Mechanochemical endovenous ablation (MOCA) might avoid these complications and reduce postoperative pain because of the absence of thermal energy. This study evaluated postoperative pain and quality of life after radiofrequency ablation (RFA) and MOCA for great saphenous vein (GSV) incompetence.. Sixty-eight patients with unilateral GSV incompetence were treated with either RFA or MOCA in this prospective observational study. Patients monitored their pain for the first 14 postoperative days on a 100-mm visual analog scale (VAS). They also completed the general (RAND 36-Item Short-Form Health Survey) and disease-specific (Aberdeen Varicose Vein Questionnaire) quality of life questionnaires before and 6 weeks after treatment.. Patients treated with MOCA reported significantly less postoperative pain than patients treated with RFA during the first 14 days after treatment (4.8 ± 9.7 mm vs 18.6 ± 17.0 mm; P < .001) (mean VAS over 14 days). The lower postoperative pain score was associated with a significantly earlier return to normal activities (1.2 ± 1.8 vs 2.4 ± 2.8 days; P = .02) and work resumption (3.3 ± 4.7 vs 5.6 ± 5.8 days, respectively; P = .02). At 6 weeks, patients in both groups perceived an improved change in health status and an improved disease-specific quality of life.. MOCA is associated with significantly less postoperative pain, faster recovery, and earlier work resumption compared with RFA in the treatment of GSV incompetence. MOCA and RFA are both related to a rapid improvement in quality of life.

Topics: Adult; Aged; Catheter Ablation; Chi-Square Distribution; Female; Health Status; Humans; Male; Middle Aged; Netherlands; Pain Measurement; Pain, Postoperative; Polidocanol; Polyethylene Glycols; Prospective Studies; Quality of Life; Registries; Saphenous Vein; Sclerosing Solutions; Sclerotherapy; Surveys and Questionnaires; Time Factors; Treatment Outcome; Venous Insufficiency