Early Experience with Diclofenac Topical Gel for Moderate to Severe Post-Ablation Phlebitis
Tuesday, March 5, 2024
3:15 PM – 4:45 PM EST
Location: Foyer
Objective: Oral (PO) non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used to treat phlebitis and thrombus extension post-endovenous ablation. However, few studies have evaluated diclofenac topical gel for treating post-ablation phlebitis. This study assesses diclofenac 1% topical gel as a first-line treatment for patients with moderate to severe phlebitis post-ablation.
Methods: From December 2021 to June 2023, a retrospective cohort study of all patients was performed to identify patients who developed post-ablation phlebitis and were treated with either diclofenac topical gel (with or without PO NSAIDs) versus PO NSAIDs alone. All patients were evaluated with a numeric pain rating scale (NPRS, 0-10) at four-time intervals (1, 7, 14, and 30 days) after initiating treatment. Likert pain scale was also evaluated with 0 = complete relief, 1 = moderate relief, 2 = slight relief, and 3 = without relief. General follow-up questions for experience, ease of use, and efficacy were also completed at follow-up.
Results: Overall, 24 patients were included in the study, with 17 in the Diclofenac ± PO NSAIDs group (4 males and 13 females) and 7 in the PO NSAIDs alone group (all females). NPRS scores showed similar pain reduction trends at all time intervals, except that the patients in the Diclofenac ± PO NSAIDs group started at a higher pain severity (Fig 1). Moreover, the Likert pain scale results were similar between the treatment groups, with partial to complete relief in most patients at 30 days. Most (65%) patients preferred the diclofenac topical gel due to ease of use and immediate local pain reduction.
Conclusions: Patients with moderate to severe post-ablation phlebitis respond well to diclofenac topical gel with or without PO NSAIDs. Moreover, patients often had significant pain relief without additional need for PO NSAIDs. Longitudinal studies are needed to support use of diclofenac topical gel for post-ablation phlebitis.
