Full-face laser resurfacing using a supplemented topical anesthesia protocol.
BACKGROUND
Laser resurfacing has become a popular modality for the treatment of photodamaged skin, rhytids, and acne scarring. In many cases, this procedure is performed under general anesthesia or intravenous sedation in conjunction with nerve blocks and local infiltration.


OBJECTIVE
To evaluate the safety and efficacy of facial carbon dioxide laser resurfacing using a supplemented topical anesthesia protocol.


METHODS
Nonrandomized case series of patients observed for 1 year.


METHODS
Outpatient surgery center.


METHODS
Two hundred consecutive patients undergoing treatment for facial rhytids or acne scarring. Intervention Full-face carbon dioxide laser resurfacing procedures were performed using a supplemented topical anesthesia protocol. Pretreatment medications included diazepam, oral analgesics, and intramuscular ketorolac tromethamine.


METHODS
Tolerability of procedure, healing times, and adverse effects.


RESULTS
Topical anesthesia provided effective and sufficient anesthesia in most cases. Only 10 of 200 patients required additional anesthesia (regional nerve blocks and/or local infiltration). Substantial improvement of rhytids, photodamage, and acne scarring was observed. Posttreatment hypopigmentation was seen in 1 patient. Scarring was not observed. Conclusion A supplemented topical anesthesia protocol for full-face laser resurfacing is a safe and effective alternative to traditional anesthesia strategies.
Kilmer
Suzanne L
SL
Laser & Skin Surgery Center of Northern California, Sacramento, CA, USA. skilmer@skinlasers.com
Chotzen
Vera
V
Zelickson
Brian D
BD
McClaren
Marla
M
Silva
Susan
S
Calkin
Jacqueline
J
No
David
D
D000152:Acne Vulgaris / Q000150:complications; D000287:Administration, Topical; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects; D002921:Cicatrix / Q000532:radiotherapy; D005145:Face / Q000528:radiation effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy; D007834:Lasers / Q000009:adverse effects*; D008012:Lidocaine / Q000008:administration & dosage* / Q000009:adverse effects; D000077442:Lidocaine, Prilocaine Drug Combination; D008297:Male; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D017060:Patient Satisfaction; D011318:Prilocaine / Q000008:administration & dosage* / Q000009:adverse effects; D015595:Skin Aging / Q000528:radiation effects; D013997:Time Factors; D016896:Treatment Outcome
D000779:Anesthetics, Local; D000077442:Lidocaine, Prilocaine Drug Combination; D011318:Prilocaine; D008012:Lidocaine