Buzzing away the pain: Using an electric toothbrush for vibration anesthesia during painful procedures

Duplisea, Michael; Flores, Kyle

doi:10.1111/pde.13802

Cited by 5 publications

(7 citation statements)

References 5 publications

(4 reference statements)

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“…We hypothesized that vibration would reduce perceived pain at injection (iNRS) in both patients who catastrophized pain and patients who did not. Vibration has been previously shown to significantly decrease pain perceived by patients in multiple clinical settings, but, to our knowledge, had not been tested in those who catastrophize pain . In our study, we found that patients who catastrophized pain experience a minimum clinically important difference in relative change (≥22%) and patients who did not catastrophize pain experience a substantial clinically important difference (≥57%) with the use of vibration during anesthetic injection (Table 3).…”

Section: Discussionmentioning

confidence: 48%

“…Vibration has been previously shown to significantly decrease pain perceived by patients in multiple clinical settings, but, to our knowledge, had not been tested in those who catastrophize pain. [23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] In our study, we found that patients who catastrophized pain experience a minimum clinically difference in relative change (≥22%) and patients who did not catastrophize pain experience a substantial clinically important difference (≥57%) with the use of vibration during anesthetic injection (Table 3). 39 During multivariate analysis of the entire cohort, the only variable to significantly affect the perceived pain of patients during anesthetic injection was the presence of the VAD (F statistic, 2.741; P = .03) (eTable in Supplement 2).…”

Section: Discussionmentioning

confidence: 88%

“…The use of nonnoxious tactile stimulation, specifically vibration, has been shown to significantly decrease pain perceived by patients in many clinical settings . Generalizability of these previous studies are limited owing to small sample size, the use of volunteers, and unreported and/or unperformed participant training for accurate pain score reporting.…”

Section: Introductionmentioning

confidence: 99%

“…8,13,21,22 The use of nonnoxious tactile stimulation, specifically vibration, has been shown to significantly decrease pain perceived by patients in many clinical settings. [23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] Generalizability of these previous studies are limited owing to small sample size, the use of volunteers, and unreported and/or unperformed participant training for accurate pain score reporting. This study aims to promote generalizability by including a typical dermatologic surgery patient population, without exclusion of previous condition(s), who are undergoing scheduled skin cancer removal surgical procedures.…”

mentioning

confidence: 99%

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Effect of a Vibratory Anesthetic Device on Pain Anticipation and Subsequent Pain Perception Among Patients Undergoing Cutaneous Cancer Removal Surgery

Govas

Kazi

Slaugenhaupt

et al. 2019

JAMA Facial Plast Surg

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IMPORTANCE Vibration has been shown to decrease injection site pain in patients; however, to date, this effect has not been assessed for patients who catastrophize pain (ie, patients who anticipate a higher pain level). The anticipation of a pain score greater than 4 on the 11-point Numeric Rating Scale (NRS) has been associated with an increase in a patient's perception of procedural pain.OBJECTIVE To assess the efficacy of vibration during cutaneous anesthetic injection for dermatologic surgery for patients who catastrophize pain (NRS score >4) and patients who do not (NRS score Յ4).DESIGN, SETTING, AND PARTICIPANTS Randomized, parallel-group clinical trial from June 19 to September 4, 2018, at a tertiary dermatologic surgery clinic among 87 adults undergoing cutaneous cancer removal surgery. Patients completed a preprocedural questionnaire detailing their baseline pain, anticipated pain, and drug use. Analysis was performed on an intent-to-treat basis.INTERVENTIONS Use of a vibratory anesthetic device (VAD) on the treatment site prior to anesthetic injection in the on (VAD ON) or off (VAD OFF) mode.MAIN OUTCOMES AND MEASURES Pain was reported using the 11-point NRS (where 0 indicates no pain and 11 indicates the worst pain imaginable). A minimum clinically important difference of 22% or more and a substantial clinically important difference of 57% or more were used to assess the efficacy of vibration in patient-reported NRS score during anesthetic injection (iNRS score).RESULTS A total of 87 patients were included, with 101 unique events reported (among the unique events, 37 were reported in women and 64 were reported in men; mean [SD] age, 66.0 [11.3] years). The mean (confidence level [CL]) iNRS score for patients who catastrophized pain was 2.27 (0.66) compared with 1.44 (0.39) for patients who did not (P = .03). A 38.9% decrease in mean (CL) iNRS score was reported with VAD ON compared with VAD OFF in all participants (1.24 [0.38] vs 2.04 [0.54]). Patients who catastrophized pain reported a 25.5% decrease in mean (CL) iNRS score with VAD ON vs VAD OFF (1.91 [0.99] vs 2.57 [0.98]), and patients who did not reported a 79.4% decrease (1.02 [0.40] vs 1.84 [0.66]). VAD ON was the only statistically significant variable to affect iNRS score (F statistic, 2.741; P = .03).CONCLUSIONS AND RELEVANCE This trial demonstrates that those who catastrophize pain prior to a procedure report a higher perceived level of pain. The application of vibration during local anesthetic injection resulted in a minimum clinically important difference in pain level for patients who catastrophize pain and a substantial clinically important difference in pain level for patients who do not. LEVEL OF EVIDENCE 2.TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT03467685

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Section: Discussionmentioning

confidence: 48%

Section: Discussionmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Effect of a Vibratory Anesthetic Device on Pain Anticipation and Subsequent Pain Perception Among Patients Undergoing Cutaneous Cancer Removal Surgery

Govas

Kazi

Slaugenhaupt

et al. 2019

JAMA Facial Plast Surg

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“…[7][8][9][10][11] Vibration has been successfully used in several clinical settings, including dermatologic surgery, pediatrics, phlebotomy, dentistry, and injectable cosmetics. 7,[12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] This has led to significant reduction in patient pain and anxiety. 28 Pain perception and response to analgesia has significant variability among age, sex, and treatment site.…”

mentioning

confidence: 99%

Differential Analgesia From Vibratory Stimulation During Local Injection of Anesthetic: A Randomized Clinical Trial

et al. 2019

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BACKGROUND-Inadequate pain reduction during anesthetic injection is a significant medical and surgical problem. Vibratory distraction reduces this pain; however, there are minimal data identifying those who respond best. OBJECTIVE-To quantify analgesia from vibration before anesthetic injection.MATERIALS AND METHODS-In this partially blinded, single-institution trial, adult participants were randomized to intervention (vibratory anesthetic device, VAD ON) or placebo (VAD OFF). Pain was assessed using the 11-point numeric rating scale (NRS). Relative reduction in NRS between VAD OFF and ON was used to identify minimum clinically important and substantially clinically important difference in pain.RESULTS-One hundred one tested sites from 87 subjects were assessed. Sixty-three percent were men with a median age of 66 years. From univariate analysis, males, subjects aged <60, and head and neck (HN) treated subjects had a significant reduction in NRS (p < .05). Multivariate analysis identified NRS reductions in females <60 (p = .012), males ≥70 (p = .002), females and males treated on HN (p = .048 and p = .035, respectively), and males ≥70 treated on HN (p = .012). Substantially clinically important difference (≥57% NRS reduction) included subjects <60, females <70, HN treatment aged 60 to 69, males ≥70, and females treated on HN.CONCLUSION-Vibratory anesthetic device reduces pain during anesthetic injection, primarily for HN treatments and older male subjects.

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Intralesional steroid injections for inflammatory nail dystrophies in the pediatric population

Iorizzo¹,

Chiacchio

et al. 2023

Pediatric Dermatology

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Intralesional injections of triamcinolone acetonide are widely used to successfully treat several inflammatory nail conditions. This procedure is well described in adults, but less frequently reported in children and teenagers, being largely considered too invasive and fear-provoking for pediatric patients. Our report shows how this procedure is feasible and successful in children, even without a digital block. The step-bystep technique and tips to reduce pain should encourage clinicians to offer it as an alternative option to children with inflammatory nail disorders.

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Buzzing away the pain: Using an electric toothbrush for vibration anesthesia during painful procedures

Cited by 5 publications

References 5 publications

Effect of a Vibratory Anesthetic Device on Pain Anticipation and Subsequent Pain Perception Among Patients Undergoing Cutaneous Cancer Removal Surgery

Effect of a Vibratory Anesthetic Device on Pain Anticipation and Subsequent Pain Perception Among Patients Undergoing Cutaneous Cancer Removal Surgery

Differential Analgesia From Vibratory Stimulation During Local Injection of Anesthetic: A Randomized Clinical Trial

Intralesional steroid injections for inflammatory nail dystrophies in the pediatric population

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