Effect of subcutaneous infiltration anesthesia on pain in photodynamic therapy: a controlled open pilot trial.
BACKGROUND
Photodynamic therapy (PDT) has been established as a treatment option for nonmelanoma skin cancer, such as superficial basal cell carcinoma, actinic keratoses, or Bowen's disease.


OBJECTIVE
A major drawback of PDT is pain during treatment that can cause extreme distress for some patients.


METHODS
This study was a controlled, open trial comparing PDT in 16 patients on one side of the face with orally administered analgesics and PDT on the contralateral side of the face with subcutaneous infiltration anesthesia (SIA). The 5-aminolevulinic acid gel was applied 5 hours before treatment. Pain was assessed by the patient using a visual analog scale directly after treatment.


RESULTS
Fifteen of 16 (94%) patients reported less pain during PDT after SIA compared to oral analgesics only. This effect was significant (Wilcoxon test for matched pairs, p= .001). No side effects due to SIA were observed.


CONCLUSIONS
SIA is an effective and rather safe method for the control of PDT-associated pain.
Borelli
Claudia
C
Department of Dermatology, Ludwig-Maximilian University, Munich, Germany. claudia.borelli@med.uni-muenchen.de
Herzinger
Thomas
T
Merk
Kathrin
K
Berking
Carola
C
Kunte
Christian
C
Plewig
Gerd
G
Degitz
Klaus
K
D000368:Aged; D000369:Aged, 80 and over; D000622:Aminolevulinic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D000772:Anesthesia, Local; D005260:Female; D005782:Gels; D006801:Humans; D007642:Keratosis; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000517:prevention & control*; D010147:Pain Measurement; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000008:administration & dosage / Q000627:therapeutic use*
D005782:Gels; D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid