[Subjective perception of pain in local dermatological surgery].
BACKGROUND
Pain is difficult to measure, as it has a significant subjective component. This symptom, and in particular its psycho-emotional component (fear prior to the operation and a feeling of release afterwards), has not been studied extensively. We decided to quantitatively evaluate its perception in local surgery, in relation to different moments during the operation and using the application of a topical anesthetic cream as an external variable.


METHODS
The perception of pain was documented with a verbal assessment scale before and during anesthesia infiltration and immediately at the end of the operation by means of three questions: 1) How much do you think it is going to hurt?, 2) How much does it hurt? and 3) How much did it hurt? In addition, the application of EMLA (topical anesthetic cream) was randomized.


RESULTS
219 patients were studied. The scores for question 2 were significantly lower than the ones for question 1, and the scores for question 3 were significantly lower than the ones for questions 1 and 2. The patients treated with EMLA only gave lower scores than the controls in questions 2 and 3.


CONCLUSIONS
Patients think that the surgery will hurt more than it really does, and they also immediately erase the memory of the recent pain. The use of EMLA does not modify the patient's idea of how much the operation will hurt, but the patient does perceive less pain than those who do not use it. It is important to reassure patients about their operations so that they do not become overly anxious about the procedures, thus minimizing their perception of pain. The use of a topical local anesthetic in the area of the surgery could help decrease the sensation of pain.
Dermatólogos, Hospital Universitario de la Princesa, Area 2 de Salud de Madrid, Diego de León 62, 28006 Madrid, Spain. mariajones@telefonica.net
María
M
Jones
Pablo
P
Fernández-Peñas
Roberto
R
Miguélez
Patricia
P
García-Morrás
Rosa M
RM
García-Cantero
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000523:psychology*; D010147:Pain Measurement; D010465:Perception; D012871:Skin Diseases / Q000601:surgery*; D013514:Surgical Procedures, Operative / Q000009:adverse effects; D011795:Surveys and Questionnaires