A Comparison of Laser-Assisted Drug Delivery at Two Output Energies for Enhancing the Delivery of Topically Applied LMX-4® Cream Prior to Venipuncture

Koh, Jeffrey L.; Harrison, D.; Swanson, Veronica C.; Norvell, Daniel C; Coomber, Darren C.

doi:10.1213/01.ane.0000257925.36641.9e

Cited by 18 publications

(17 citation statements)

References 6 publications

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“…86 Another randomized, double-blind, crossover study of adults compared the efficacy and adverse-event profile for laser-assisted delivery of topical anesthetic before venipuncture using 2 output energies (2.0 and 3.5 J/cm 2 ). 89 Mean VAS pain scores were not statistically different (P ϭ .57) between the low-energy (mean ϭ 6.7) and high-energy (mean ϭ 8.1) lasers.…”

Section: Laser-assisted Local Anesthetic Deliverymentioning

confidence: 83%

Pharmacologic Approaches for Reducing Venous Access Pain in Children

Zempsky

2008

Pediatrics

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A variety of pharmacologic options are available to clinicians who want to provide effective and safe topical local anesthesia to children undergoing venous access procedures. These options can be distinguished on the basis of how they deliver active drug through the impermeable outer layer of skin, the stratum corneum, to pain receptors located in the dermis and epidermis. Three general methodologies are typically used to bypass the stratum corneum: direct injection of local anesthetics, usually via a small-gauge hypodermic syringe; passive diffusion from topical creams or gels; and active needle-free drug strategies that enhance the rate of drug passage into the dermis and epidermis. Examples of the latter mechanisms include heatenhanced diffusion, iontophoresis, sonophoresis, laser-assisted transdermal passage, and pressurized gas delivery of powdered drug particles. Pharmacologic options in this setting can also be distinguished on the basis of the time to onset of full anesthetic effect. Several available agents induce significant local anesthesia within 1 to 3 minutes of administration, or faster, allowing easy integration into the skin preparation and subsequent venous access procedure. In combination with nonpharmacologic approaches, these agents can be used to dramatically lessen this significant source of pediatric pain. Pediatrics 2008;122:S140-S153

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Section: Laser-assisted Local Anesthetic Deliverymentioning

confidence: 83%

Pharmacologic Approaches for Reducing Venous Access Pain in Children

Zempsky

2008

Pediatrics

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“…There appears to be no diminution in the degree of analgesia at lower energy laser settings (2.0 J/cm 2 ), compared to the high energy (3.5 J/cm 2 ) settings used in the aforementioned studies, as inferred from an intra-individual study of 30 patients comparing both settings, with one used on each antecubital fossa [35].…”

Section: Local Anaestheticsmentioning

confidence: 87%

Laser-assisted drug delivery in dermatology: from animal models to clinical practice

Ali

Al‐Niaimi

2015

Lasers Med Sci

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Topical medicaments are the mainstay of the dermatologists' therapeutic arsenal. Laser-assisted drug delivery enhances the ability of topically applied medicaments to penetrate the skin. We discuss the mechanisms of laser-assisted drug delivery and animal models that have informed clinical practice. We review clinical studies that have employed laser-assisted drug delivery for a range of indications to date including non-melanoma skin cancer, vitiligo, scarring, vaccination, local anaesthesia, analgesia, viral warts, infantile haemangiomas and cosmetic uses. Studies thus far suggest that laser pre-treatment improves transepidermal absorption of topical agents and allows for a much deeper penetration of drugs than is possible with topical medicaments alone. This may allow more efficacious action of current treatments, such that conventional duration of treatment can be shortened or lower concentrations of active agents be used, potentially obviating side effects of treatment. The prospect of using laser technologies to facilitate transdermal vaccination and as an adjunct for inflammatory dermatoses and cosmetic indications remains in its infancy. As larger trials are published, involving greater numbers of patients and utilising various laser and topical medicament parameters, we will enhance our understanding of this nascent modality of treatment delivery.

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“…For the second pass, the average pain score at the beginning was 3.4 (range, [3][4]; it rose to 3.6 during treatment (range, 2-6) and, by the end of the treatment, reached a peak of 4.0 (range, 2-6). All patients stated that they would undergo repeat treatments with this method of analgesia again.…”

Section: Group Bmentioning

confidence: 95%