Author: Dr. Qiang Zhang, Dr. Xin Du, Dr. Lei Su, Dr. Jianping Deng, et al.
Varicose veins are a common venous disease that significantly affects patients’ quality of life. With advances in medical technology, the treatment options for varicose veins have become more diverse. These include CHIVA (Conservative Hemodynamic Cure for Venous Insufficiency), sclerotherapy, stripping surgery, and endovenous thermal ablation (radiofrequency ablation and laser ablation). This article compares the pain experiences associated with these treatments to help patients and doctors choose the most appropriate treatment method.
Pain Scoring Method
This article uses the Visual Analog Scale (VAS) to evaluate the pain experiences of each treatment method. The VAS score ranges from 0 to 10, with 0 indicating no pain and 10 indicating severe pain. The detailed comparison of each treatment method is as follows:
CHIVA Treatment
- Pain Scores:
- Intraoperative Pain: 2/10
- Postoperative Pain: 2/10
- Pain Experience: CHIVA treatment is usually performed under local anesthesia with small incisions, resulting in minimal pain during the procedure. Postoperative pain is relatively mild due to the minimal trauma, and recovery is quick. Most patients can resume activities immediately after the procedure, with pain lasting for a short duration.
Sclerotherapy
- Pain Scores:
- Intraoperative Pain: 3/10
- Postoperative Pain: 4/10
- Pain Experience: Sclerotherapy typically does not use anesthesia, but the injection itself may cause mild stinging and discomfort. Postoperatively, localized pain, inflammatory reactions, and hardening may occur, generally ranging from mild to moderate in severity. These discomforts can be alleviated with compression stockings and pain medication.
Stripping Surgery
- Pain Scores:
- Intraoperative Pain: 0/10 (under general or regional anesthesia)
- Postoperative Pain: 7/10
- Pain Experience: Stripping surgery is performed under general or regional anesthesia, resulting in no pain during the procedure. However, postoperative pain becomes apparent as the anesthesia wears off. Due to significant surgical trauma and multiple incisions, postoperative pain is quite pronounced, often requiring pain medication, with a longer recovery time.
Endovenous Thermal Ablation (Radiofrequency Ablation and Laser Ablation)
- Pain Scores:
- Intraoperative Pain: 3/10
- Postoperative Pain: 5/10
- Pain Experience: Endovenous thermal ablation is typically performed under local anesthesia with tumescent anesthesia assistance, resulting in mild pain during the procedure, though a burning sensation and discomfort may occur. Postoperatively, localized pain, bruising, and burning sensations may occur, usually of moderate intensity. These can be alleviated with compression stockings and pain medication. Postoperative pain duration is relatively short, with most patients resuming daily activities within a few days.
Conclusion
From a pain perspective, CHIVA treatment has the least intraoperative and postoperative pain, with VAS scores of 2/10 and 2/10, respectively. Sclerotherapy pain scores are 3/10 and 4/10. Endovenous thermal ablation pain scores are 3/10 and 5/10. Stripping surgery has the most significant postoperative pain, with a score of 7/10. Patients should choose a treatment method based on their individual condition and pain tolerance, in consultation with their doctor.
By comparing these pain scores, this article aims to provide more information for patients, helping them make more informed decisions when treating varicose veins.