Pain and analgesia following sclerotherapy for venous and lymphatic malformations in children

Bennett E*, Todd R**, Sury M***
University of Glasgow*, University of Glasgow**, University of Glasgow***
Address for Correspondence:Ella Bennett, University of Glasgow, UK. Email:

Aim:Sclerotherapy is the gold standard treatment for lymphatic and venous malformations. This project aims to describe the pain caused by sclerotherapy and the level of analgesia needed in the first 24hours post-operatively.

Methods:All patients undergoing percutaneous lymphatic and venous sclerotherapy during a 4-week period were observed. Intra-operative analgesia was selected by the anesthetist, recorded and standardized using dose per kilogram. In recovery, each patient’s pain score, the type of score used and additional analgesia received, if any, were noted. These details were recorded for a second time 1 – 2 hours after leaving recovery, when the patient returned to the ward.

Results: Elevenof the 20(55%) patients reported pain post-operatively. Of these, 4 patients experienced pain in recoveryand 7 patients experienced pain on the ward.Of these, 54.5% of these patients requiredsupplementary analgesia with 2 requiring oral morphine.In addition to this, the use of formal pain scores in recovery was low; 71% were done on the ward and 30% of children had no formal pain score performed at all. Only 3 children were scored both in recovery and on the ward.

Conclusion:As this study was purely observational, it is impossible to draw any conclusions as to the relative effectiveness of fentanyl and morphine as intra-operative prophylactic analgesia. The study has however, highlighted a difficulty in the consistent and reliable monitoring of pain. Further data on the use of pain scores and the reliability of differentscoring methods would aid the assessment of appropriate analgesia administration.
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