Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Center for Advanced Analytics, Baptist Health South Florida, Florida; Department of Biostatistics, Robert Stempel College of Public Health, Miami, Florida; Department of Biostatistics, Florida International University, Miami, Florida; Division of Cardiology Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.
J Am Acad Dermatol. 2023 Jul;89(1):114-118. doi: 10.1016/j.jaad.2023.02.049. Epub 2023 Mar 10.
Patients awake during staged cutaneous surgery procedures may experience procedure-related pain.
To determine whether the level of pain associated with local anesthetic injections prior to each Mohs stage increases with subsequent Mohs stages.
Multicenter longitudinal cohort study. Patients rated pain (visual analog scale: 1-10) after anesthetic injection preceding each Mohs stage.
Two hundred fifty-nine adult patients presenting for Mohs who required multiple Mohs stages at 2 academic medical centers were enrolled; 330 stages were excluded due to complete anesthesia from prior stages, and 511 stages were analyzed. Mean visual analog scale pain ratings were nominally but not significantly different for subsequent stages of Mohs surgery (stage 1: 2.5; stage 2: 2.5; stage 3: 2.7: stage 4:2.8: stage 5: 3.2; P = .770). Between 37% and 44% experienced moderate pain, and 9.5% and 12.5% severe pain, during first as versus subsequent stages (P > .05) LIMITATIONS: Both academic centers were in urban areas. Pain rating is inherently subjective.
Patients did not report significantly increased anesthetic injection pain level during subsequent stages of Mohs.
在分阶段进行皮肤手术过程中，患者可能会感到与手术相关的疼痛。
确定在每个 Mohs 阶段之前进行局部麻醉注射时与疼痛相关的水平是否会随着随后的 Mohs 阶段而增加。
多中心纵向队列研究。患者在每个 Mohs 阶段之前的麻醉注射后对疼痛进行评分（视觉模拟量表：1-10）。
在 2 家学术医疗中心，共有 259 名成年患者接受 Mohs 治疗，需要进行多次 Mohs 手术；由于前一阶段完全麻醉，排除了 330 个阶段，共分析了 511 个阶段。Mohs 手术后续阶段的视觉模拟量表疼痛评分均值略有但无统计学意义（第 1 阶段：2.5；第 2 阶段：2.5；第 3 阶段：2.7；第 4 阶段：2.8；第 5 阶段：3.2；P=0.770）。约 37%至 44%的患者在第一阶段和后续阶段经历中度疼痛，9.5%和 12.5%的患者经历重度疼痛（P＞0.05）。
两个学术中心都位于城市地区。疼痛评分具有内在的主观性。
患者在 Mohs 的后续阶段并未报告麻醉注射疼痛水平显著增加。
