Regular NSAID prescription after treatment for varicose veins: a feasibility study

IntroductionThe National Health Service (NHS) in England performs more than 35,000 varicose veins procedures annually to treat superficial venous incompetence (SVI). Around 1 in 10 patients experience significant pain in the first post-procedural week, which frequently affects quality of life (QoL). This feasibility study aimed to assess the effectiveness of routinely prescribed non-steroidal anti-inflammatory drugs (NSAIDs) for pain management following treatment for SVI, and to examine the feasibility of conducting a randomised controlled trial (RCT).MethodsEligible patients undergoing endovenous thermal ablation (EVTA) and/or concomitant phlebectomy for SVI were enrolled. Patients in the intervention group were prescribed Ibuprofen three times daily for five days following treatment. A 1:1 propensity score matched cohort using the nearest neighbour method with a calliper of 0.2 was derived from participants enrolled in a previous trial. Feasibility outcomes included the eligibility rate, recruitment rate, study completion rate, diary completion rate, and intervention adherence rate. Clinical outcomes included daily post-procedural visual analogue scale (VAS) pain scores recorded over seven days and NSAID-related adverse effects documented in patient pain diaries.ResultsOf the 56 patients assessed for study participation, the eligibility rate was 88% (n = 49) and the recruitment rate was 73% (n-36). The study completion rate was 69% (n-25). The diary completion rate was 50% (n = 18). The intervention adherence rate was 6-% (n = 15). There were no statistically significant differences in median pain scores between the two groups. No major NSAID-related adverse effects were reported.ConclusionRoutine post-procedural NSAID use was not associated with a statistically significant reduction in pain following EVTA and phlebectomy for SVI. However, this study demonstrated the feasibility of conducting an adequately powered RCT of NSAIDs for pain management following treatment for SVI and generated data to inform the design of such a trial.