Murison M S C, Tucker S C
Department of Plastic Surgery, Morriston Hospital, Swansea SA6 5NL, UK.
J Plast Reconstr Aesthet Surg. 2007;60(4):432-6. doi: 10.1016/j.bjps.2006.04.008. Epub 2006 Jun 12.
Laser resurfacing is a painful procedure, and is therefore usually carried out under general anaesthetic or local anaesthetic with sedation. However, the small but significant risk of adverse events from either of these methods has resulted in an effort to develop other methods of controlling the pain associated with the use of lasers. This trial describes of the use of a cooling device (the CoolAnalgesia device) with a carbon dioxide laser. The only anaesthetic used was a eutectic mixture of lidocaine anaesthetic (EMLA) applied as a cream to the face at least 60 min prior to the procedure. Twenty consecutive patients attending two laser centres for facial resurfacing were recruited. Each patient was asked to assess the level of pain on a visual analogue scale from 1-10 every 2 min during lasering. Only one of the patients had a mean pain score for the duration of the treatment of above five, four patients recorded a pain score of above five at some stage during their treatment, but none requested that the treatment be stopped. It would appear that the CoolAnalgesia device in combination with EMLA cream provides a level of anaesthesia sufficient to allow laser resurfacing without the use of local anaesthetic injections or intra-venous agents.
激光换肤是一种痛苦的手术，因此通常在全身麻醉或局部麻醉加镇静的情况下进行。然而，这两种方法都存在虽小但显著的不良事件风险，这促使人们努力开发其他控制与激光使用相关疼痛的方法。本试验描述了一种冷却装置（CoolAnalgesia装置）与二氧化碳激光联合使用的情况。唯一使用的麻醉剂是利多卡因麻醉剂的共晶混合物（EMLA），在手术前至少60分钟以乳膏形式涂抹于面部。招募了连续20名到两个激光中心进行面部换肤的患者。在激光治疗期间，要求每位患者每2分钟在1至10的视觉模拟量表上评估疼痛程度。只有一名患者在整个治疗过程中的平均疼痛评分高于5分，四名患者在治疗的某个阶段记录到疼痛评分高于5分，但没有人要求停止治疗。看来，CoolAnalgesia装置与EMLA乳膏联合使用可提供足够的麻醉水平，无需使用局部麻醉注射或静脉用药就能进行激光换肤。
