The efficiency of pain control using a thigh pad under the elastic stocking in patients following venous stripping: Results of a case-control study

摘要

Background. The use of a specific thigh foam pad placed under compression stockings increases interface pressure. The interface pressure obtained under 2 medical compression stockings of 15 to 20 mm Hg at the ankle, is 14 ± 2.2 mm Hg in the middle of the thigh in the horizontal position and rises to 49.2 ± 4.7 mm Hg when an appropriate thigh foam pad is interposed. Thigh compression could be useful in relieving pain after surgery of the great saphenous vein. Objective. The aim of this study was to compare pain intensity on day 1 and day 7 and global mean pain during the week after stripping of the great saphenous vein between patients to whom a pad has been added at the thigh level under the compression stocking (case) and patients wearing a compression stocking only (control). Methods. Case-control study conducted in daily surgical practice by patients having undergone surgical stripping. Main criteria: pain self-evaluation on visual analogue scale from day 1 to day 7 adjusted for analgesic consumption. No pain evaluation was conducted on Day 0 because of the fact that the elastic compression was applied in the operating room on a patient still under anesthesia. Results. A total of 53 patients were included in the study: 36 in the pad group and 17 in the control group. Patients were similar in respect of age, sex ratio, body mass index, professional status, and CEAP (clinical, etiologic, anatomic, and pathophysiologic) classification. On day 1, pain was 40.8 ± 20.8 in the control group and 27.4 ± 24.2 in the pad group (P =.05). On day 7, pain was 15.3 ± 13.4 in the control group and 3.7 ± 5.5 in the pad group (P <.0001). Global mean pain during the week after stripping surgery was 156.5 ± 80.6 in the control group and 80.1 ± 82.01 in the pad group (P <.0001). Conclusion. The results of this case-control study show that the addition of a pad at thigh level under the elastic compression stocking significantly reduces pain experienced by patients during the week after stripping surgery by 49%.