Avaliação da dor em criocirurgia de ceratoses actínicas

Abstract

INVESTIGATIONAbstract: BACKGROUND: Background: Actinic kera to sis is a fre quently-encoun te red pre ma lig nant lesion occur ring in areas expo sed to sun light in fair-skin ned elderly or mid dle-aged peo ple. Cryosurgery with liquid nitro gen is the most com mon method for trea ting the lesions. OBJECTIVES: The pri mary objec ti ve of this study was to mea su re the inten sity of pain during cryo sur gery by using the Visual Analog Scale (VAS). We also sought to iden tify the pain level dee med appro pria te by the patient, to assess the pro por tion of patients who con si de red it neces sary to redu ce the pain and, finally, to gauge whe ther or not addi tio nal anal ge sia was requi red. METHODS: Cross-sec tio nal study with patients refer red for cryo sur gi cal treat ment of acti nic kera to ses to the Sanitary Dermatology Outpatient Clinic. We applied a ques tion nai re to 112 patients [48 men (42.8%) and 64 women (57.2%)] after their treat ment for acti nic kera to ses, asking them to assess the inten sity of pain expe rien ced during sur gery and the pain that they con si de red to be bea ra ble or appro pria te for the pro ce du re. RESULTS: The mean refer red pain during sur gery was 32.85 mm on the Visual Analog Scale, while the mean pain dee med appro pria te by the patients was 23.01 mm. The dif fe ren ce bet ween the two means was sta tis ti cally sig ni fi cant (p <0.05). 30.4% of the patients repor ted in the direct and objec ti ve ques tion nai re that they nee ded the pain to be redu ced. CONCLUSIONS: Although the level of pain con si de red to be appro pria te by the patients was sta tis ti cally lower than the refer red pain, it did not reach the level at which it would be jud ged neces sary to pro vi de addi tio nal anal ge sia in this type of inter ven tion. Keywords: Actinic kera to sis; Cryosurgery; Pain mea su re ment Resumo: FUNDAMENTOS: a cera to se actí ni ca é lesão pré-malig na fre quen te, que ocor re em áreas expos tas à luz solar, em pes soas ido sas ou adul tas de meia-idade e pele clara. A crio ci rur gia com nitro gê nio líqui do é a moda li da de mais comum para o tra ta men to de cera to ses actí ni cas. Objetivos: o obje ti vo pri má rio deste estu do foi medir a inten si da de da dor duran te a crio ci rur gia, por meio da Escala Visual Análoga. Também bus cou-se iden ti fi car o nível de dor con side ra do ade qua do pelo pacien te, ava liar a pro por ção de pacien tes que con si de ram neces sá ria a dimi nui ção da dor senti da e veri fi car a neces si da de ou não de anal ge sia suple men tar. Métodos: Estudo trans ver sal com pacien tes enca mi nhados para tera pêu ti ca crio ci rúr gi ca de cera to ses actí ni cas no Ambulatório de Dermatologia Sanitária. Foram ava lia dos 112 pacien tes, após tra ta men to de cera to ses actí ni cas, apli can do-se um ques tio ná rio com per gun tas sobre a inten si dade da dor sen ti da duran te o pro ce di men to cirúr gi co, assim como a dor con si de ra da con for tá vel ou ade qua da ao proce di men to. Resultados: par ti c...

Study of skin neoplasms in a university hospital: integration of anatomopathological records and its interface with the literature

“…It is well known that cryotherapy with liquid nitrogen is a destructive procedure and highly effective, with cure rates between 75 and 99%. 15…”

Actinic keratoses: review of clinical, dermoscopic, and therapeutic aspects

“…Cryotherapy is a destructive method used for the isolated treatment of actinic keratoses, which uses liquid nitrogen (LN) to achieve tissue freezing and thawing processes, leading to tissue destruction 182 . Cryotherapy is the treatment of choice in patients presenting isolated or small numbers of lesions without field cancerization.…”

“…Cryotherapy is the treatment of choice in patients presenting isolated or small numbers of lesions without field cancerization. The technique consists in applying LN as a spray or in an object that exerts direct pressure on the skin, such as a swab 182 . LN temperature is −196 °C, and ideally it reaches approximately −50 °C in contact with the skin.…”

Randomized clinical trial testing the efficacy and safety of 0.5% colchicine cream versus photodynamic therapy with methyl aminolevulinate in the treatment of skin field cancerization: study protocol

“…Cryotherapy with liquid nitrogen, which is the most common AK treatment, is well tolerated, easily accessible and shows good clinical and histopathological results (clinical response of 83% with a freezing time longer than 20 s) [ 12 ]. Discomfort during the application and post-procedure hypochromia can occur and may persist [ 13 ]. Cryotherapy treats only visible lesions, making it a good treatment for AKs, but this therapy does not treat skin field cancerization [ 14 ].…”