Observation of Pain During Radiofrequency Ablation of Saphenous Vein,and Analysis of Related Factors
2026年6月28日 更新者:Chunshui He、Chengdu University of Traditional Chinese Medicine
Objective: This study is a single-center prospective observational study, which recorded the pain scores of patients at four time nodes during surgery (puncture and catheterization, injection of swelling fluid, radiofrequency generator work, and end of surgery), and analyzed the correlation between intraoperative pain and age, gender, BMI and other factors, so as to summarize and improve the details of surgery and reduce patients' intraoperative pain.
調査の概要
状態
状態
完了
条件
条件
介入・治療
介入・治療
詳細な説明
Although the global vascular surgeons have made significant progress in the study of RFA in the treatment of VVs, there are still many unknown areas to be explored, and the current research mainly focuses on the surgical effect of RFA and related complications, while the research on intraoperative pain is relatively scarce.
First of all, RFA does not have a clear definition of intraoperative pain in the treatment of varicose veins of the lower extremities, so it has not received enough attention in clinical practice, and many doctors regard the success of surgery as the end point of treatment, but ignore the impact of intraoperative pain on the patient's surgical experience.
In addition, with the continuous progress of varicose vein surgery of the lower extremities, the anesthesia method has also changed from general anesthesia to combined spinal-epidural block to today's local anesthesia, the swollen anesthetic solution is the main anesthetic drug used in RFA surgery, and the infiltration of the swollen anesthetic fluid around the saphenous vein is the key to the success of RFA, but paradoxically, this is also the most intense part of the patient's pain, the swollen fluid is usually a crystalloid solution containing local anesthetic and epinephrine, which is acidic in nature, which is also the main reason for the "tingling" during skin infiltration , A Cochrane review noted that adjusting the pH of lidocaine solution by adding sodium bicarbonate significantly reduced the pain reported on a 10 cm visual analogue scale (VAS) during skin infiltration, and that the temperature of the swollen anesthetic solution also had an effect on pain during skin infiltration, Bell et al. and Alonso et al.
In a prospective randomized controlled trial, it was found that heating the local anesthetic solution to 37°C and 42°C reduced pain sensation, and heating the local anesthetic solution containing epinephrine to near body temperature was effective in reducing the pain of local anesthetic infiltration in patients, however, in a randomized clinical trial in 2018, patients were divided into cold swollen fluid group (4 °C) and room temperature swollen fluid group (24 °C), and the authors found that patients in the cold swollen fluid group had less pain during and after RFA, The amount of postoperative analgesics was significantly reduced.
Therefore, the patient's pain during RFA has become a problem that we must pay attention to, and the operator should pay attention to the details and pay attention to the patient's intraoperative condition during RFA, so as to reduce the patient's intraoperative pain and give the patient a better surgical experience.
研究の種類
研究の種類
観察的
入学 (実際)
入学
155
連絡先と場所
このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。
研究場所
-
-
Sichuan
-
Chengdu、Sichuan、中国、610000
- Hospital of Chengdu University of Traditional Chinese Medicine
-
-
参加基準
研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。
適格基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
いいえ
サンプリング方法
確率サンプル
調査対象母集団
Patients diagnosed with primary VVs from April 2023 to September 2023 who were admitted to the hospital and underwent RFA treatment for the main trunk of the saphenous vein
説明
Inclusion Criteria:
- Age≥ 18 years old, ≤ 90 years old;
- the patient's life expectancy is greater than 12 months;
- The clinical diagnosis is primary VVs, CEAP classification C2-C6, and the GSV segment needs to be treated, including pain, burning sensation, heaviness, fatigue, itchy skin, night cramps and other clinical symptoms;
- Doppler ultrasound confirmed that the diameter of GSV was greater than 3mm and less than 12mm when standing;
- Doppler ultrasound confirms that GSV is located in the saphenofascia or the distance between GSV and the skin surface is >1cm;
- radiofrequency ablation treatment only for unilateral GSV walking area;
- The patient is willing to cooperate with the completion of the examination specified in the protocol.
Exclusion Criteria:
- GSV thrombosis, or combined with deep vein thrombosis, or previous history of deep vein thrombosis and pulmonary embolism;
- patients with recurrence after prior VVs-related surgery (C2r);
- the GSV trunk is severely distorted, and it is expected that the catheter will not be able to pass;
- Severe ischemia of the lower limbs, Ankle brachial pressure index (ABPI) < 0.8;
- Known allergy to the drugs and device materials involved in the study;
- Previously implanted with a pacemaker or defibrillator, and currently receiving regular anticoagulation therapy (such as warfarin, heparin);
- Pregnant or lactating females;
- Patients who are unable or unwilling to participate in the study;
- Participating in the research of other drugs or devices;
- Skin malignancies other than non-melanoma that are being treated;
- daily use of narcotic drugs or non-steroidal anti-inflammatory drugs to control pain caused by venous disease;
- The investigator judged that endovenous treatment was not suitable;
研究計画
このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。
研究はどのように設計されていますか?
デザインの詳細
グループ/コホートの数
1
コホートと介入
グループ/コホートグループ/コホート |
介入・治療介入・治療 |
|---|---|
|
Observation of Pain During Radiofrequency Ablation of Saphenous Vein,and Analysis of Related Factors
Among the 155 patients were evaluated by our team with CEAP grading and ultrasound measurements to record the diameter of the saphenous vein before surgery, and the procedure of radiofrequency ablation of the saphenous vein trunk supplemented with sclerotherapy was applied to record the data of the operating room temperature, puncture site, and the VAS scores of the puncture and tube placement, injection of the swelling fluid, radiofrequency generator, and the end of the procedure.
The patients' intraoperative pain scores were descriptively analyzed to assess the degree of intraoperative pain, and non,parametric tests were applied to analyze the correlation between preoperative and intraoperative factors and intraoperative pain.
|
この研究は何を測定していますか?
主要な結果の測定
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Puncture catheterization
時間枠:At the time of surgery
|
The pain during puncture and catheterization mainly comes from needle breakage, local anesthetic infiltration and vascular sheath insertion, the 7F vascular puncture sheath group was used in this study, the diameter of the puncture needle is 1.27mm, the pain during skin puncture is stronger than that of the syringe needle used for intravenous or intramuscular injection, there is a well-designed randomized controlled use of an automatic injection device to standardize the injection parameters, and the use of smaller needles also forces the injector to slow down the injection rate, which can reduce the pain of the patient
|
At the time of surgery
|
|
Inject swollen fluid
時間枠:At the time of surgery
|
In this study, a 0.7mm needle was used to inject lidocaine into the skin around the puncture point, which can be replaced with a 0.5mm needle to slow down the injection rate of lidocaine, reduce the stinging sensation of the patient, and place the vascular sheath after the local anesthetic infiltrates the skin, which can slightly reduce the pain of the vascular sheath entering the blood vessel through the skin.
Similarly, a 0.7mm needle is used to inject swelling fluid from the puncture point along the main trunk of the saphenous vein, the longer the length of the patient's ablation vein, the number of skin breaks will increase, but the patient's pain will not increase with the accumulation of skin breaks, and the operator can reduce the pain of the patient's injection of swelling fluid by squeezing, pressing, stretching the skin, and inserting the needle vertically
|
At the time of surgery
|
協力者と研究者
ここでは、この調査に関係する人々や組織を見つけることができます。
出版物と役立つリンク
研究に関する情報を入力する責任者は、自発的にこれらの出版物を提供します。これらは、研究に関連するあらゆるものに関するものである可能性があります。
一般刊行物
- Kubat E, Unal CS, Geldi O, Cetin E, Keskin A. What is the optimal treatment technique for great saphenous vein diameter of >/=10 mm? Comparison of five different approaches. Acta Chir Belg. 2021 Apr;121(2):94-101. doi: 10.1080/00015458.2019.1684008. Epub 2019 Oct 25.
- Bozoglan O, Mese B, Eroglu E, Erdogan MB, Erdem K, Ekerbicer HC, Yasim A. Comparison of Endovenous Laser and Radiofrequency Ablation in Treating Varicose Veins in the Same Patient. Vasc Endovascular Surg. 2016 Jan;50(1):47-51. doi: 10.1177/1538574415625813. Epub 2016 Jan 14.
- Nandhra S, Wallace T, El-Sheikha J, Leung C, Carradice D, Chetter I. A Randomised Clinical Trial of Buffered Tumescent Local Anaesthesia During Endothermal Ablation for Superficial Venous Incompetence. Eur J Vasc Endovasc Surg. 2018 Nov;56(5):699-708. doi: 10.1016/j.ejvs.2018.05.017. Epub 2018 Jun 29.
- Cepeda MS, Tzortzopoulou A, Thackrey M, Hudcova J, Arora Gandhi P, Schumann R. Adjusting the pH of lidocaine for reducing pain on injection. Cochrane Database Syst Rev. 2010 Dec 8;(12):CD006581. doi: 10.1002/14651858.CD006581.pub2.
- Arendt-Nielsen L, Egekvist H, Bjerring P. Pain following controlled cutaneous insertion of needles with different diameters. Somatosens Mot Res. 2006 Mar-Jun;23(1-2):37-43. doi: 10.1080/08990220600700925.
- Egekvist H, Bjerring P, Arendt-Nielsen L. Pain and mechanical injury of human skin following needle insertions. Eur J Pain. 1999 Mar;3(1):41-49. doi: 10.1053/eujp.1998.0099.
- Gill HS, Prausnitz MR. Does needle size matter? J Diabetes Sci Technol. 2007 Sep;1(5):725-9. doi: 10.1177/193229680700100517.
研究記録日
これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。
主要日程の研究
研究開始 (実際)
研究開始
2024年7月1日
一次修了 (実際)
一次修了
2024年9月1日
研究の完了 (実際)
研究の完了
2024年9月1日
試験登録日
最初に提出
最初に提出
2024年7月29日
QC基準を満たした最初の提出物
QC基準を満たした最初の提出物
2026年6月28日
最初の投稿 (実際)
最初の投稿
2026年7月6日
学習記録の更新
投稿された最後の更新 (実際)
投稿された最後の更新
2026年7月6日
QC基準を満たした最後の更新が送信されました
QC基準を満たした最後の更新が送信されました
2026年6月28日
最終確認日
最終確認日
2024年7月1日
詳しくは
本研究に関する用語
キーワード
その他の研究ID番号
その他の研究ID番号
- chengduUTCMvs6
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
いいえ
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
いいえ
米国FDA規制機器製品の研究
いいえ
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。