Iontophoresis for anesthesia during pulsed dye laser treatment of port-wine stains.
Port-wine stains (PWS) are benign, congenital vascular malformations found in approximately 0.3% of newborns. PWS may be effectively treated with the flashlamp pulsed dye laser (FPDL) at 585 nm. However, laser therapy of vascular lesions often produces pain. We performed a prospective double-blind, placebo-controlled evaluation of the iontophoresis of lidocaine 5% with epinephrine 1:50,000 and mepivacaine 2% with epinephrine 1:50,000. Thirty-six patients with facial PWS were included in the study; 13 of them were treated with lidocaine 5% with epinephrine, another 13 were treated with mepivacaine 2% with epinephrine, and the other 13 were treated with preservative-free 0.9% NaCl. The pain was graded by the patient on a visual analog scale from 0 to 10, comparing the iontophoretically treated area with an adjacent area treated without anesthesia. Pain evaluation by patients demonstrated a significant decrease in the pain of pulsed dye laser impulses using the iontophoresis of lidocaine 5% with epinephrine. No change in the efficacy of pulsed dye laser treatment of PWS or important side effects were observed in our patients. Iontophoresis of lidocaine 5% with epinephrine is a safe and effective method of local anesthesia for pulsed dye laser and it is more effective than the iontophoresis of mepivacaine 2% with epinephrine.
Núñez
M
M
Servicio de Dermatología, Hospital Ramón y Cajal, Universidad de Alcalá, Madrid, Spain.
Miralles
E S
ES
Boixeda
P
P
Gómez
F
F
Pérez
B
B
Abraira
V
V
Ledo
A
A
D000293:Adolescent; D000779:Anesthetics, Local / Q000008:administration & dosage; D002648:Child; D004311:Double-Blind Method; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007478:Iontophoresis; D053685:Laser Therapy; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008619:Mepivacaine / Q000008:administration & dosage; D019339:Port-Wine Stain / Q000601:surgery*; D011446:Prospective Studies
D000779:Anesthetics, Local; D008012:Lidocaine; D008619:Mepivacaine; D004837:Epinephrine