Chapter: Pain therapy and anesthesia
Article: 2 of 8
Update: Feb 24, 2021
Author(s): Kramer, Jens
Various types of pain can occur during the natural course of a vascular malformation and also during the course of treatment. Basically, pain can be classified according to its origin or cause as well as its duration.
Pain is triggered by the excitation of nociceptors in the tissue. These free nerve endings can be stimulated by various stimuli: endogenous chemical stimuli (e.g., prostaglandins, cytokines, etc.), exogenous stimuli (pressure, heat, cold, etc.).
The following types of pain arise, depending on localization and region in the body:
|Nociceptive pain||Soft tissue|
(connective tissue, muscle,
|Neuropathic pain||Various triggers and|
sources of damage:
The pain experienced prior to treatment of a vascular malformation can in many cases indicate the underlying nature of the vascular malformation:
of venous malformations
|High venous pressure due to|
reflux or central stenosis
of arteriovenous malformations
with venous hypertension
The timing of the onset of pain also plays a role.
Immediately during treatment, intervention/surgery:
With regard to the development and treatment of chronic pain, not only in the context of vascular malformations, two important descriptions apply: multifactorial and interdisciplinary.
Common methods for quantifying the intensity of pain are a numerical ranking scale (NRS) or the visual analog scale (VAS). These involve visualizing or ranking the pain intensity using symbols (e.g., smiley, color) or numbers, depending on the patient’s age or language barriers.
Scientific measurement of health-related quality of life by means of special questionnaires that patients fill out themselves can also yield quantitative information about pain intensity. One example is the SF-36 Version 2 pain scale, which is available in various translations.