GIẢM ĐAU KHI ĐIỀU TRỊ SẸO LỒI (Thứ sáu, 10 tháng 02, 2017)

Published in Dermatology

Topical Anesthetic and Lidocaine Mixture for Pain Relief During Keloid Treatment

TAKE-HOME MESSAGE

• This small double-blind, randomized controlled trial (N = 40) showed a significant reduction in needle-stick pain scores in the groups who received topical anesthetic (2 mm–thick EMLA). The group who received a 1:1 mixture of 1% lidocaine and triamcinolone reported pain scores similar to those reported by the control group.
• Topical anesthetics may relieve needle-stick pain during triamcinolone injection in the treatment of keloids.

– InYoung Kim, MD, PhD

BACKGROUND

Keloids are abnormal overgrowth of collagen fibers, and the first-line treatment includes intralesional injection of triamcinolone acetonide (TA), which is associated with pain.

OBJECTIVE

To study the benefit of applying topical anesthetics or a 1:1 mixture of 1% lidocaine and TA at the TA injection site to alleviate pain during keloid treatment.

METHODS AND MATERIALS

A double-blind, randomized controlled trial was conducted. Four TA injection methods were tested: control, lidocaine, topical, and combined. A visual analog scale (VAS) was used to assess needle-stick and injection pain. Data on pain duration after injection were also collected.

RESULTS

Forty patients were enrolled (mean age, 37.1 years). The VAS scores of needle-stick pain in the control, lidocaine, topical, and combined groups were 4.18 ± 2.12, 3.82 ± 2.48, 2.03 ± 2.02, and 2.20 ± 1.99, respectively. Pain statistically decreased in the topical and combined groups. Intralesional injection pain (VAS) scores in the control, lidocaine, topical, and combined groups were similar as follows: 4.97 ± 2.50, 4.97 ± 2.79, 4.10 ± 2.80, and 4.43 ± 2.68, respectively.

CONCLUSION

Application of topical anesthetics significantly relieved needle-stick pain, especially at sternum and auricular keloids; administration of a lidocaine mixture did not alleviate pain during injection.