Morphine Gel 0.3% Does Not Relieve Pain During Topical Photodynamic Therapy: A Randomized, Double-blind, Placebo-controlled Study

Skiveren, Jette; Hædersdal, Merete; Philipsen, Peter Alshede; Wiegell, Stine Regin; Wulf, Hans Christian

doi:10.2340/00015555-0128

Cited by 67 publications

(49 citation statements)

References 20 publications

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“…The application of local anaesthetics like lidocaine/prilocaine substances prior to illumination is generally not recommended. As previously shown also application of morphine 0.3% gel 15 min prior to illumination did not result in a significant reduction of pain as compared to a placebo gel [46].…”

Section: Practical Application Tolerability and Side Effectssupporting

confidence: 54%

Photodynamic Therapy and Skin Cancer

Papakonstantinou¹,

Löhr²,

Raap³

2018

Dermatologic Surgery and Procedures

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Non-melanoma skin cancer (NMSC) is the most common type of cancer among white skin individuals worldwide with an increasing incidence over the last years. NMSC is mostly treated with surgical or non-invasive methods such as cryotherapy or topical chemotherapeutics. Over the last years, there has been a rapidly growing interest in the use of photodynamic therapy (PDT) which is a well-tolerated, safe and effective alternative treatment option. PDT involves a photosensitizer, a light source and tissue oxygen and is based on a photo-oxidation reaction in the target tissue which results to a selective destruction of the cancer cells. PDT has been approved for treatment of actinic keratosis, Bowen's disease and basal cell carcinoma in Europe. Off-label uses include treatment of invasive squamous cell carcinoma, cutaneous T-cell lymphoma, Kaposi's sarcoma, Paget's disease and prevention of recurrence of squamous cell carcinoma in organ-transplant recipients. Also combination of PDT with other treatment options such as cryotherapy, surgery and topical therapies has been reported with improved efficacy, tolerability and long-term results. Development of novel photosensitizers and light sources together with targeted delivery systems will increase specificity, efficiency and treatment field of PDT in the future. This chapter aims to give the reader an overview of the important applications of PDT, including indications, approved treatments, advantages and disadvantages of this method such as future trends.

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Section: Practical Application Tolerability and Side Effectssupporting

confidence: 54%

Photodynamic Therapy and Skin Cancer

Papakonstantinou¹,

Löhr²,

Raap³

2018

Dermatologic Surgery and Procedures

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“…Several studies have been conducted to examine the various topical pain relief methods during PDT, without convincing results (26)(27)(28)(29)(30). In a recent study by Tyrell et al (31), the use of air cooling as pain relief resulted in less protoporphyrin IX photobleaching and consequently in reduced efficacy.…”

Section: Discussionmentioning

confidence: 96%

Patients’ Experiences of Pain and Pain Relief During Photodynamic Therapy on Actinic Keratoses: An Interview Study

Halldin¹,

Gonzalez²,

Wennberg³

et al. 2013

Acta Derm Venerol

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Photodynamic therapy (PDT) is a well-known, effective method for treating extensive areas of multiple actinic keratoses in the face and scalp. The main side-effect of PDT is the pain experienced during treatment. The objective of this study was to explore and describe patients' experiences of PDT. The study used individual interviews, and analysis was carried out using phenomenography. The patients had all been treated with PDT for actinic keratoses on the face and scalp, and experienced PDT with and without nerve blocks. The results are presented in 3 themes and 10 categories. Most patients reported that the nerve blocks given prior to PDT altered their experience of pain. Alternative options are needed to reduce pain during PDT based on patients' needs and body site. This study adds a patient perspective highlight-ing patients' own voices as a qualitative complement to statistical analysis using the visual analogue scale.

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“…12,14e16 It has previously been reported that morphine gel 13 and tetracaine gel 24 can be inadequate analgesia for PDT patients.…”

Section: Discussionmentioning

confidence: 99%