Iliac vein stenting is an option being explored to treat chronic venous insufficiency. We have noted that our most common postoperative complication is low back pain after stent placement, which is occasionally quite severe. We wanted to investigate risk factors that are involved in this phenomenon and identify potentially modifiable factors. Patients who failed 3 months of conservative therapy had iliac vein interrogation performed. We limited the scope of this database to non-thrombotic iliac vein lesions treated in the office in which Wallstents were placed. Data were collected from September 2012 to August 2020 for 2308 consecutive outpatients who underwent 3747 procedures. Before August 2016, patients received pre-procedure oral valium (n = 2679) and thereafter, patients received intravenous (IV) sedation (n = 1068). A pain score, on a Likert scale ranging from 0 to 10, was assessed within 1 hour postoperatively. We analyzed the medications administered and correlated them with pain scores. The average of all the pain scores was 0.86 (range, 0-10; standard deviation [SD], 2.00). Age had a slight inverse effect on pain scores (r = −0.12; < .00001). Presenting signs (based upon CEAP) ( = .11) and body mass index ( = .88) did not have a significant effect on pain scores. Average pain score for females (0.96) was slightly higher than for males (0.70), with < .0001. Average pain score for procedures on the right side (0.67) was lower than for procedures on the left side (1.01), with < .0001. Average pain score for patients who received IV sedation (mean, 0.68; SD, 1.58) was lower than that for those who did not (mean, 0.93; SD, 2.15), with = .0004. When using a single agent, propofol was associated with the lowest pain scores ( < .0001). Toradol displayed a dose-dependent effect on pain score ( < .0001). The best combination of agents for pain control was propofol and toradol together. Overall, the vast majority of pain scores were low. Factors that were associated with lower pain scores were older age, male sex, procedures on the right side, and IV sedation, in particular with the use of propofol. These data may help us better target patients anticipated to have high pain scores and suggest the preferential use of propofol and toradol.

中文翻译：

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非血栓性髂静脉病变髂静脉支架置入术后腰痛的危险因素

髂静脉支架置入术是治疗慢性静脉功能不全的一种选择。我们注意到，最常见的术后并发症是支架置入后的腰痛，有时会相当严重。我们想要调查与这种现象有关的风险因素，并确定潜在的可改变因素。保守治疗 3 个月失败的患者进行了髂静脉检查。我们将该数据库的范围限制为在放置 Wallstents 的办公室中治疗的非血栓性髂静脉病变。数据收集自 2012 年 9 月至 2020 年 8 月期间连续 2308 名门诊患者接受了 3747 次手术。 2016 年 8 月之前，患者术前接受口服安定 (n = 2679)，此后患者接受静脉 (IV) 镇静 (n = 1068)。术后 1 小时内评估疼痛评分，按李克特量表从 0 到 10 分。我们分析了所服用的药物并将其与疼痛评分相关联。所有疼痛评分的平均值为 0.86（范围，0-10；标准差 [SD]，2.00）。年龄对疼痛评分有轻微的反向影响 (r = −0.12; < .00001)。出现体征（基于 CEAP）（= .11）和体重指数（= .88）对疼痛评分没有显着影响。女性平均疼痛评分 (0.96) 略高于男性 (0.70)，< .0001。右侧手术的平均疼痛评分 (0.67) 低于左侧手术的平均疼痛评分 (1.01)，< .0001。接受静脉注射镇静的患者的平均疼痛评分（平均 0.68；SD，1.58）低于未接受静脉注射镇静的患者（平均 0.93；SD，2.15），= 0.0004。当使用单一药物时，异丙酚与最低的疼痛评分相关 (<.0001)。 Toradol 对疼痛评分显示出剂量依赖性效应 (< .0001)。控制疼痛的最佳药物组合是异丙酚和托拉多。总体而言，绝大多数疼痛评分较低。与较低疼痛评分相关的因素包括年龄较大、男性、右侧手术和静脉注射镇静，尤其是使用异丙酚。这些数据可以帮助我们更好地瞄准预计具有高疼痛评分的患者，并建议优先使用异丙酚和托拉多。