A Topical Anesthetic and Lidocaine Mixture for Pain Relief During Keloid Treatment: A Double-Blind, Randomized Controlled Trial.

Abstract

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.

• Authors: Arnik Usanakornkul, Chairat Burusapat
• Journal: Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] (Dermatol Surg) Vol. 43 Issue 1 Pg. 66-73 (Jan 2017) ISSN: 1524-4725 [Electronic] United States
• PMID: 28027198 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Anesthetics, Local
• Anti-Inflammatory Agents
• Lidocaine
• Triamcinolone Acetonide

Topics

• Administration, Cutaneous
• Adolescent
• Adult
• Aged
• Anesthetics, Local (administration & dosage)
• Anti-Inflammatory Agents (therapeutic use)
• Double-Blind Method
• Ear Auricle
• Female
• Humans
• Injections, Intralesional (adverse effects)
• Keloid (drug therapy)
• Lidocaine (administration & dosage)
• Male
• Middle Aged
• Pain (etiology, prevention & control)
• Pain Measurement
• Shoulder
• Thorax
• Triamcinolone Acetonide (therapeutic use)
• Young Adult