Luo Di-Qing, Yang Wei
Department of Dermatology, Huangpu Hospital of The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, PR China.
Photomed Laser Surg. 2010 Apr;28(2):213-7. doi: 10.1089/pho.2008.2462.
To evaluate the anesthetic efficacy of topical application of 1% tetracaine gel before and after a Q-switched neodymium-doped yttrium aluminium garnet (Nd:YAG) laser procedure.
A variety of topical anesthetics are available for painful cutaneous procedures, including laser treatments, which are applied before treatment.
Seventy-nine adults were assigned to Q-switched laser treatment at a wavelength of 532 nm (freckle, chloasma, and seborrheic keratosis) and 1064 nm (nevus fusco-caeruleus zygomaticus, nevus of Ota). Based on application time of tetracaine, there were three groups receiving each wavelength: 5 minutes before treatment, and 10 minutes before treatment, and after the procedure. Patients' lesions were divided into tetracaine-treated area and margin, which were treated with the same laser dose and wavelength. The energy density was 2 J/cm(2) for 532 nm and 5 J/cm(2) for 1064 nm. The pain relief score (PRS) for all groups, the latency time, and the time to maximal anesthesia of tetracaine for the after-procedure group were recorded. The PRSs were rated on visual analog scales.
The mean PRSs +/- standard deviation of the group receiving the tetracaine 10 minutes before the procedure (42.37 +/- 9.18) were higher than the scores of those receiving it 5 minutes before (26.32 +/- 5.49)with the 532-nm laser. Using the gel after the procedure and using the 1064-nm and 532-nm lasers, the latency time was 20 to 80 seconds, the duration to maximal anesthesia was 2 to 6 minutes, and the maximum PRSs were 70 to 100, higher than the scores of those receiving tetracaine 10 minutes before the procedure (P < 0.001). The gel was well tolerated.
Topical application of 1% tetracaine gel provides better anesthesia used 10 minutes before Q-switched Nd:YAG laser treatment than 5 minutes before but provides superior anesthesia and shorter latency time when applied after the procedure.
评估调Q掺钕钇铝石榴石（Nd:YAG）激光治疗前后局部应用1%丁卡因凝胶的麻醉效果。
多种局部麻醉剂可用于包括激光治疗在内的疼痛性皮肤操作，这些麻醉剂在治疗前应用。
79名成年人被分配接受波长为532nm（雀斑、黄褐斑和脂溢性角化病）和1064nm（颧部褐青色痣、太田痣）的调Q激光治疗。根据丁卡因的应用时间，接受每种波长治疗的患者分为三组：治疗前5分钟、治疗前10分钟和治疗后。患者的皮损分为丁卡因治疗区和边缘区，用相同的激光剂量和波长进行治疗。532nm的能量密度为2J/cm²，1064nm的能量密度为5J/cm²。记录所有组的疼痛缓解评分（PRS）、潜伏期以及治疗后组丁卡因达到最大麻醉的时间。PRS采用视觉模拟评分法进行评定。
使用532nm激光时，术前10分钟接受丁卡因治疗组的平均PRS±标准差（42.37±9.18）高于术前5分钟接受治疗组的评分（26.32±5.49）。术后使用该凝胶并使用1064nm和532nm激光时，潜伏期为20至80秒，达到最大麻醉的持续时间为2至6分钟，最大PRS为70至100，高于术前10分钟接受丁卡因治疗组的评分（P<0.001）。该凝胶耐受性良好。
局部应用1%丁卡因凝胶在调Q Nd:YAG激光治疗前10分钟使用比术前5分钟使用提供更好的麻醉效果，但在术后应用时提供更好的麻醉效果且潜伏期更短。
