Park Kui Young, Lee Yohan, Hong Ji Yeon, Chung Won Soon, Kim Myeung Nam, Kim Beom Joon
*Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea; †Lexington High School, Lexington, Massachusetts; ‡Yonsei Star Skin & Laser Clinic, Seoul, Korea.
Dermatol Surg. 2017 May;43(5):724-727. doi: 10.1097/DSS.0000000000001040.
Patients suffer significant pain during intralesional steroid injection treatment for keloids and hypertrophic scars. Vibration anesthesia has been shown to effectively and safely alleviate pain sensations, likely by reducing pain transmission from peripheral receptors to the brain.
The objective was to evaluate the efficacy, safety, and patient satisfaction associated with vibration anesthesia for reducing pain during intralesional corticosteroid injection.
The authors recruited 40 patients with 58 keloids who were scheduled to undergo intralesional triamcinolone acetonide (TA) injections. Half of each keloid was injected with concomitant vibration anesthesia, whereas the other half was injected without vibration anesthesia. Pain experienced by patients during both procedures was assessed according to visual analog scale (VAS) score. The authors also assessed procedure safety.
The mean VAS score during intralesional TA injection therapy without vibration was 5.88 ± 2.34. By contrast, the same patients yielded a mean VAS score during intralesional TA injection therapy with vibration of 3.28 ± 1.85; the difference between the mean scores was significant (p < .05). Thirty-nine (97.5%) patients tolerated this therapy well.
Vibration anesthesia is a promising option for reducing pain during keloid treatment with intralesional steroid injection.
在瘢痕疙瘩和增生性瘢痕的病灶内注射类固醇治疗期间，患者会遭受严重疼痛。振动麻醉已被证明能有效且安全地减轻疼痛感，可能是通过减少从外周感受器到大脑的疼痛传递来实现的。
评估振动麻醉在病灶内注射皮质类固醇时减轻疼痛方面的疗效、安全性及患者满意度。
作者招募了40例患有58个瘢痕疙瘩且计划接受病灶内注射曲安奈德（TA）的患者。每个瘢痕疙瘩的一半在注射时同时采用振动麻醉，而另一半在注射时不采用振动麻醉。根据视觉模拟量表（VAS）评分评估患者在两种操作过程中所经历的疼痛。作者还评估了操作安全性。
在不采用振动的病灶内TA注射治疗期间，平均VAS评分为5.88±2.34。相比之下，同一批患者在采用振动的病灶内TA注射治疗期间的平均VAS评分为3.28±1.85；平均分之间的差异具有统计学意义（p<0.05）。39例（97.5%）患者对该治疗耐受良好。
振动麻醉是在病灶内注射类固醇治疗瘢痕疙瘩时减轻疼痛的一种有前景的选择。
