Patterns, incidence and predictive factors for pain after interventional radiology.
OBJECTIVE
To evaluate prospectively the pattern, severity and predictive factors of pain after interventional radiological procedures.


METHODS
All patients undergoing non-arterial radiological interventional procedures were assessed using a visual-analogue scale (VAS) for pain before and at regular intervals for 24 h after their procedure.


RESULTS
One hundred and fifty patients (87 men, mean age 62 years, range 18-92 years) were entered into the study. Significant increases in VAS score occurred 8 h after percutaneous biliary procedures (+47.7 mm, SD 14.9 mm; p=0.001), 6 h after central venous access and gastrostomy insertion (+23.7 mm, SD 19.5 mm; p=0.001 and +28.4 mm, SD 9.7 mm; p=0.007, respectively) and 4h after oesophageal stenting (+27.8 mm, SD 20.2 mm, p=0.001). Non-significant increases in VAS pain score were observed after duodenal and colonic stenting (duodenal: +5.13 mm, SD 7.47 mm; p=0.055, colonic: +23.3 mm, SD 13.10 mm, p=0.250) at a mean of 5h (range 4-6h). Patients reported a significant reduction in pain score for nephrostomy insertion (-28.4mm, SD 7.11 mm, p=0.001). Post-procedural analgesia was required in 99 patients (69.2%), 40 (28.0%) requiring opiates. Maximum post-procedural VAS pain score was significantly higher in patients who had no pre-procedural analgesia (p=0.003).


CONCLUSIONS
Post-procedural pain is common and the pattern and severity of pain between procedures is variable. Pain control after interventional procedures is often inadequate, and improvements in pain management are required.
England
A
A
Department of Radiology, South Manchester University Hospitals NHS Trust, Southmoor Road, Manchester, UK. andrew.england@smtr.nhs.uk
Tam
C L
CL
Thacker
D E
DE
Walker
A L
AL
Parkinson
A S
AS
Demello
W
W
Bradley
A J
AJ
Tuck
J S
JS
Laasch
H-U
HU
Butterfield
J S
JS
Ashleigh
R J
RJ
England
R E
RE
Martin
D F
DF
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000698:Analgesia / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects; D010146:Pain / Q000209:etiology*; D010147:Pain Measurement / Q000379:methods; D011446:Prospective Studies; D015642:Radiology, Interventional; D012307:Risk Factors; D012720:Severity of Illness Index; D015607:Stents / Q000009:adverse effects