title: Pain evaluation in the cryosurgery of actinic keratoses.
abstract: BACKGROUND
  Background: Actinic keratosis is a frequently-encountered premalignant lesion occurring in areas exposed to sunlight in fair-skinned elderly or middle-aged people. Cryosurgery with liquid nitrogen is the most common method for treating the lesions.
  
  
  OBJECTIVE
  The primary objective of this study was to measure the intensity of pain during cryosurgery by using the Visual Analog Scale (VAS). We also sought to identify the pain level deemed appropriate by the patient, to assess the proportion of patients who considered it necessary to reduce the pain and, finally, to gauge whether or not additional analgesia was required.
  
  
  METHODS
  Cross-sectional study with patients referred for cryosurgical treatment of actinic keratoses to the Sanitary Dermatology Outpatient Clinic. We applied a questionnaire to 112 patients [48 men (42.8%) and 64 women (57.2%)] after their treatment for actinic keratoses, asking them to assess the intensity of pain experienced during surgery and the pain that they considered to be bearable or appropriate for the procedure.
  
  
  RESULTS
  The mean referred pain during surgery was 32.85 mm on the Visual Analog Scale, while the mean pain deemed appropriate by the patients was 23.01 mm. The difference between the two means was statistically significant (p <0.05). 30.4% of the patients reported in the direct and objective questionnaire that they needed the pain to be reduced.
  
  
  CONCLUSIONS
  Although the level of pain considered to be appropriate by the patients was statistically lower than the referred pain, it did not reach the level at which it would be judged necessary to provide additional analgesia in this type of intervention.
authors: Hospital São Lucas, PUC-RS, Brazil.
authors: Claudia Schermann
authors: CS
authors: Poziomczyk
authors: Bruna
authors: B
authors: Köche
authors: Marcel de Almeida
authors: Mde A
authors: Dornelles
authors: Sérgio Ivan Torres
authors: SI
authors: Dornelles
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003452:Cryosurgery / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D055623:Keratosis, Actinic / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods*