European radiology · 2025
Efficacy of 75% alcohol wet compress therapy for iodinated contrast media extravasation: a randomized controlled trial.
СтатьяРандомизированное исследованиеМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Wen Xueke, Huang Wanmin, Liao Chao, Zhao Xinyan, Xu Ge, Wang Xiaolin, Su Jiaqiong, Yang Guanghui, Shi Jinghua, Wu Xuewei, Tan Wei, Zhang Bin, Luo Chunliu
Аннотация
OBJECTIVE: To evaluate the efficacy of 75% alcohol wet compression as a noninvasive treatment for contrast medium extravasation (CMEX) during contrast-enhanced computed tomography (CECT).
MATERIALS AND METHODS: This randomized controlled trial, conducted from February 1, 2019, to July 1, 2023, at six tertiary centers, involved participants undergoing CMEX during CECT. They were randomized (1:1:1:1) into four groups: 75% alcohol wet compress (AG), 50% magnesium sulfate wet compression (MG), 0.05% dexamethasone wet compression (DG), and routine care (RG). The primary outcome was the percentage change in the swelling area from baseline to 4 h, 24 h, 48 h, and 72 h, categorized as < 25%, 25-50%, 50-75%, and 75-100%. Secondary outcomes included pain reduction and quality of life improvement over 3 days, assessed using the visual analog pain intensity scale (VAS) and dermatology life quality index (DLQI), respectively.
RESULTS: Overall, 168 participants were randomized with balanced baseline characteristics. At 24 h, 48 h, and 72 h, AG and DG had significantly higher response rates (75-100%) than MG and RG (all p < 0.001), with no differences between AG and DG (all p > 0.05). AG showed greater reductions in pain score (ΔVAS: 4.88 vs 3.52 vs 3.29 vs 3.19, p < 0.001) and DLQI score (ΔDLQI: 11.60 vs 7.81 vs 7.86 vs 7.48, p < 0.001) than DG, MG, and RG.
CONCLUSION: The 75% alcohol wet compress was as effective as the 0.05% dexamethasone wet compression and superior to other CMEX treatment methods, providing more effective pain relief and improving the quality of life.
TRIAL REGISTRATION: ClinicalTrials.gov Identifier: ChiCTR2300067692.
KEY POINTS: Question Can 75% alcohol wet compression outperform standard treatments for CMEX in reducing swelling, alleviating pain, and improving quality of life? Findings Seventy-five percent alcohol compresses rival dexamethasone's efficacy while surpassing other treatments for pain and quality-of-life outcomes. Clinical relevance Seventy-five percent alcohol wet compression provides a steroid-free CMEX treatment, effectively resolving extravasation like dexamethasone while offering superior pain control and quality-of-life enhancement, potentially transforming clinical practice.
MATERIALS AND METHODS: This randomized controlled trial, conducted from February 1, 2019, to July 1, 2023, at six tertiary centers, involved participants undergoing CMEX during CECT. They were randomized (1:1:1:1) into four groups: 75% alcohol wet compress (AG), 50% magnesium sulfate wet compression (MG), 0.05% dexamethasone wet compression (DG), and routine care (RG). The primary outcome was the percentage change in the swelling area from baseline to 4 h, 24 h, 48 h, and 72 h, categorized as < 25%, 25-50%, 50-75%, and 75-100%. Secondary outcomes included pain reduction and quality of life improvement over 3 days, assessed using the visual analog pain intensity scale (VAS) and dermatology life quality index (DLQI), respectively.
RESULTS: Overall, 168 participants were randomized with balanced baseline characteristics. At 24 h, 48 h, and 72 h, AG and DG had significantly higher response rates (75-100%) than MG and RG (all p < 0.001), with no differences between AG and DG (all p > 0.05). AG showed greater reductions in pain score (ΔVAS: 4.88 vs 3.52 vs 3.29 vs 3.19, p < 0.001) and DLQI score (ΔDLQI: 11.60 vs 7.81 vs 7.86 vs 7.48, p < 0.001) than DG, MG, and RG.
CONCLUSION: The 75% alcohol wet compress was as effective as the 0.05% dexamethasone wet compression and superior to other CMEX treatment methods, providing more effective pain relief and improving the quality of life.
TRIAL REGISTRATION: ClinicalTrials.gov Identifier: ChiCTR2300067692.
KEY POINTS: Question Can 75% alcohol wet compression outperform standard treatments for CMEX in reducing swelling, alleviating pain, and improving quality of life? Findings Seventy-five percent alcohol compresses rival dexamethasone's efficacy while surpassing other treatments for pain and quality-of-life outcomes. Clinical relevance Seventy-five percent alcohol wet compression provides a steroid-free CMEX treatment, effectively resolving extravasation like dexamethasone while offering superior pain control and quality-of-life enhancement, potentially transforming clinical practice.