The use of subcutaneous infusion tumescent anesthesia in photodynamic therapy pain control

Debu, A.; Sleth, Jean-Christian; Girard, C.; Bessis, Didier; Guillot, B.; Blatiere, Véronique

doi:10.1111/j.1460-9592.2012.03857.x

Cited by 4 publications

(3 citation statements)

References 5 publications

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“…on the use of subcutaneous infiltration of ropivacaine 1% with prilocaine 1% for PDT pain relief showed benefit, although there were significant adverse effects of cheek swelling persisting for up to 3 days, which could limit its use . This has been supported in a separate case report showing the benefit of subcutaneous anaesthesia for pain relief during PDT in a 7‐year‐old child …”

Section: Painmentioning

confidence: 77%

Adverse effects of topical photodynamic therapy: a consensus review and approach to management

et al. 2018

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Section: Painmentioning

confidence: 77%

Adverse effects of topical photodynamic therapy: a consensus review and approach to management

et al. 2018

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“…The use of epinephrine in particular could lead to this. Infiltration of local anaesthetics has earlier been used during illumination with lidocaine/prilocaine cum ropivacaine, and also cum epinephrine, with good treatment success 38,39 . However, our pain management protocol did not affect the results.…”

Section: Discussionmentioning

confidence: 87%

Hexyl aminolevulinate, 5‐aminolevulinic acid nanoemulsion and methyl aminolevulinate in photodynamic therapy of non‐aggressive basal cell carcinomas: A non‐sponsored, randomized, prospective and double‐blinded trial

Salmivuori

Grönroos

Tani

et al. 2020

Acad Dermatol Venereol

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Background In the photodynamic therapy (PDT) of non-aggressive basal cell carcinomas (BCCs), 5-aminolevulinic acid nanoemulsion (BF-200ALA) has shown non-inferior efficacy when compared with methyl aminolevulinate (MAL), a widely used photosensitizer. Hexyl aminolevulinate (HAL) is an interesting alternative photosensitizer. To our knowledge, this is the first study using HAL-PDT in the treatment of BCCs. Objectives To compare the histological clearance, tolerability (pain and post-treatment reaction) and cosmetic outcome of MAL, BF-200 ALA and low-concentration HAL in the PDT of non-aggressive BCCs. Methods Ninety-eight histologically verified non-aggressive BCCs met the inclusion criteria, and 54 patients with 95 lesions completed the study. The lesions were randomized to receive LED-PDT in two repeated treatments with MAL, BF-200 ALA or HAL. Efficacy was assessed both clinically and confirmed histologically at three months by blinded observers. Furthermore, cosmetic outcome, pain, post-treatment reactions fluorescence and photobleaching were evaluated. Results According to intention-to-treat analyses, the histologically confirmed lesion clearance was 93.8% (95% confidence interval [CI] = 79.9-98.3) for MAL, 90.9% (95% CI = 76.4-96.9) for BF-200 ALA and 87.9% (95% CI = 72.7-95.2) for HAL, with no differences between the arms (P = 0.84). There were no differences between the arms as regards pain, post-treatment reactions or cosmetic outcome. Conclusions Photodynamic therapy with low-concentration HAL and BF-200 ALA has a similar efficacy, tolerability and cosmetic outcome compared to MAL. HAL is an interesting new option in dermatological PDT, since good efficacy is achieved with a low concentration.

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“…Topical anaesthetics have not been shown to be helpful, nor has topical morphine helped . Large volumes of infiltrative local anaesthetic can be useful; ‘ordinary’ subcutaneous infiltrative anaesthetics have not been well studied. The rate of illumination is a factor, with portable illumination devices that allow doses to be given over longer times and the use of daylight, as a relatively low output source, causing less pain than conventional PDT …”

mentioning

confidence: 99%

Interventions for the pain of topical photodynamic therapy

Dawe

2015

Br J Dermatol

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The use of subcutaneous infusion tumescent anesthesia in photodynamic therapy pain control

Cited by 4 publications

References 5 publications

Adverse effects of topical photodynamic therapy: a consensus review and approach to management

Adverse effects of topical photodynamic therapy: a consensus review and approach to management

Hexyl aminolevulinate, 5‐aminolevulinic acid nanoemulsion and methyl aminolevulinate in photodynamic therapy of non‐aggressive basal cell carcinomas: A non‐sponsored, randomized, prospective and double‐blinded trial

Interventions for the pain of topical photodynamic therapy

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