Vibration Anesthesia for Pain Reduction During Intralesional Steroid Injection for Keloid Treatment

Park, Kui Young; Lee, Yohan; Hong, Ji Yeon; Chung, Woo Sik; Kim, Myeung Nam; Kim, Beom Joon

doi:10.1097/dss.0000000000001040

Cited by 18 publications

(25 citation statements)

References 9 publications

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“…Intralesional injection therapy without vibration was yielded mean visual analog scores of 5.88 ± 2.34 compared to 3.28 ± 1.85 ( P < .05) when vibration was used. 14 This study included a variety of located keloids, with only a third located head or neck. Notably, each of these studies used a control group of no intervention.…”

Section: Discussionmentioning

confidence: 99%

“…6 There was reporting of one patient who felt her keloid pain was worse with the use of vibration. 14 From the topical standpoint, ice packs are considered cumbersome and not completely effective at reducing or eliminating injection pain. 2 Extra time and cost, albeit small, have also been described as drawbacks.…”

Section: Discussionmentioning

confidence: 99%

“…6,9 The ''gate-control'' theory, initially proposed in 1965, suggests that intensity of pain can be mitigated by concurrent non-noxious stimulation. 10,11 Studies have applied this theory to eyelid local anesthesia injections, 12 dermal filler injections, 13 and keloid steroid injections 14 with reduction in pain outcomes. Thermally anesthetizing the skin with topical ice has also been shown to be an effective method of reducing facial botulinum toxin injection pain.…”

Section: Introductionmentioning

confidence: 99%

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Vibration Versus Ice to Reduce Cosmetic Botulinum Toxin Injection Pain—A Randomized Controlled Trial

Chorney

Villwock

Suryadevara

2019

Ear, Nose & Throat Journal

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Botulinum toxin is the most commonly performed facial cosmetic procedure and pain at the injection site is a frequent patient concern. While various topical interventions have been described for analgesia, there have not been any studies comparing different techniques. We compared the use of a vibratory stimulus, ice pack application, and no intervention on injection site pain for cosmetic botulinum toxin injection. A prospective-, randomized-, individual-controlled study was conducted using a visual analog scale to assess pain. Patients received bilateral glabellar injections, with randomization into unilateral vibration, unilateral ice application, or vibration and ice on either side. We analyzed 88 injections on 22 patients. Mean visual analog scores were 26.5 (standard deviation [SD]: 23.1) among injections with vibration, 24.4 (SD: 22.9) with ice, and 29.4 (SD: 27.1) without analgesia. There was no significant difference in pain scale scores with the use of vibration, ice, or no topical anesthesia ( P = .737). Further, pain scale scores did not differ significantly between medial and lateral injections nor did patients have a reduction in pain on either side of the forehead regardless of which method was used. While there may be a role for topical interventions to improve injection site analgesia, we maintain that consistently proper technique plays a greater role in improving patient tolerance. Future studies will continue to investigate the role of topical anesthesia in cosmetic facial injections and address patient-specific factors contributing to discomfort.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Vibration Versus Ice to Reduce Cosmetic Botulinum Toxin Injection Pain—A Randomized Controlled Trial

Chorney

Villwock

Suryadevara

2019

Ear, Nose & Throat Journal

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“…However, for keloids less thick than 4 mm, PSR was administered without the steroid injection. 17 After PSR, a total of 18 Gy of radiation were administrated in two fractions, 24 hours posttreatment and again 1 week later. We regard adjuvant radiotherapy important in the prevention of recurrence.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Keloids Using Plasma Skin Regeneration Combined with Radiation Therapy Under the Evaluation of Patient and Observer Scar Assessment Scale

Ting¹,

Chong²,

Xu³

et al. 2021

CCID

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Keloids are caused by uncontrolled excessive proliferation of fibrous tissue. Multiple treatment strategies including steroid injection, surgical excision, laser therapy and radiation therapy have been reported. Few studies have evaluated the performance of plasma skin regeneration (PSR) in the treatment of keloid. This study aimed to evaluate the effectiveness of PSR combined with radiation therapy for keloids on different body parts. Patients and Methods: A total of 71 patients with 98 keloids were enrolled in this study. Keloids <4 mm thick underwent single-dose PSR, while keloids ≥4 mm thick were administered compound betamethasone injection beforehand. Radiation therapy was administered after 24 hours and again 7 days later after PSR. The outcome was evaluated using the patient and observer scar assessment scale at 12 months post-treatment. Results: Patient-reported average scores for all keloids significantly decreased from 35.05 ±9.94 to 21.84±7.04 (p < 0.05). Keloids on face and neck, chest, and back responded better than those on shoulders and limbs. The recurrence rate was observed to be 15.3% (15 out of 98). Adverse effects were mild. Conclusion: PSR combined with radiation therapy is an effective and safe strategy to treat keloids. Location could be a factor that affects curative effects.

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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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Vibration Anesthesia for Pain Reduction During Intralesional Steroid Injection for Keloid Treatment

Abstract: Vibration anesthesia is a promising option for reducing pain during keloid treatment with intralesional steroid injection.

Cited by 18 publications

References 9 publications

Vibration Versus Ice to Reduce Cosmetic Botulinum Toxin Injection Pain—A Randomized Controlled Trial

Vibration Versus Ice to Reduce Cosmetic Botulinum Toxin Injection Pain—A Randomized Controlled Trial

Treatment of Keloids Using Plasma Skin Regeneration Combined with Radiation Therapy Under the Evaluation of Patient and Observer Scar Assessment Scale

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

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